Cited by 28Cardiovascular Effects of ExerciseCardiomyopathy and Myosin StudiesCardiac electrophysiology and arrhythmias

Established and Emerging Mechanisms in the Pathogenesis of Arrhythmogenic Cardiomyopathy: A Multifaceted Disease

Open access
Gao, Shanshan, Puthenvedu, Deepa, Lombardi, Raffaella, Chen, Suet Nee·2020·International Journal of Molecular Sciences

Abstract

Arrhythmogenic cardiomyopathy (ACM) is a heritable myocardial disease that manifests with cardiac arrhythmias, syncope, sudden cardiac death, and heart failure in the advanced stages. The pathological hallmark of ACM is a gradual replacement of the myocardium by fibroadiposis, which typically starts from the epicardium. Molecular genetic studies have identified causal mutations predominantly in genes encoding for desmosomal proteins; however, non-desmosomal causal mutations have also been described, including genes coding for nuclear proteins, cytoskeleton componentsand proteins involved in excitation-contraction coupling. Despite the poor prognosis, currently available treatments can only partially control symptoms and to date there is no effective therapy for ACM. Inhibition of the canonical Wnt/β-catenin pathway and activation of the Hippo and the TGF-β pathways have been implicated in the pathogenesis of ACM. Yet, our understanding of the molecular mechanisms involved in the development of the disease and the cell source of fibroadiposis remains incomplete. Elucidation of the pathogenesis of the disease could facilitate targeted approaches for treatment. In this manuscript we will provide a comprehensive review of the proposed molecular and cellular mechanisms of the pathogenesis of ACM, including the emerging evidence on abnormal calcium homeostasis and inflammatory/autoimmune response. Moreover, we will propose novel hypothesis about the role of epicardial cells and paracrine factors in the development of the phenotype. Finally, we will discuss potential innovative therapeutic approaches based on the growing knowledge in the field.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/ijms21176320

Cites

142 of 142 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Epicardial cells contribute by transdifferentiating into fibro-adipogenic progenitors.

    “Epicardial cells additionally contribute by transdifferentiating into fibro-adipogenic progenitors [104,105] via pathways described in Section 4.2 and Section 4.4.”

    From A Paradigm Shift: Arrhythmogenic Cardiomyopathy Is an Inflammatory Disease (2026) · cites this paper as [105]

    Section 5.4 proposes that epicardial progenitor cells may differentiate directly into fibroadipocytes, and reports that a small fraction of fibroadipocytes derive from them. It does not say that epicardial cells transdifferentiate into fibro-adipogenic progenitors; it suggests the epicardium's main role in ACM is paracrine. Section 5.3 describes cardiac fibro-adipogenic progenitors as a distinct resident cell population. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 143 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Gao, S., Puthenvedu, D., Lombardi, R., & Chen, S. N.
Affiliations
University of Colorado Anschutz (US)
Corresponding author
  • Lombardi, Raffaella
  • Chen, Suet Nee
Venue
International Journal of Molecular Sciences
Publisher
MDPI AG
Published
2020-08-31
Volume
21
Issue
17
Pages
6320
ISSN
1422-0067 (ISSN-L)
OpenAlex
W3082832662
Cited by
28
References
143
Citations by year
2026: 3 · 2025: 4 · 2024: 1 · 2023: 8 · 2022: 5 · 2021: 6 · 2020: 1
FWCI
0.85
Type
journal article
Language
en
Open access
Locations
  • International Journal of Molecular Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • American Heart Association (19CDA34660035)
  • Boettcher Foundation (25A9520)
  • Research Projects of National Interest from the Ministry of University and Research grant (20173ZWACS)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
arrhythmogenic cardiomyopathy, pathogenesis, excitation-contraction coupling, calcium homeostasis, inflammation, autoimmunity, epicardial cells, paracrine factors, Wnt/β-catenin signaling, Hippo signaling pathway, TGF-beta signaling, sudden cardiac death, treatment options
MeSH terms
Animals, Arrhythmias, Cardiac, Humans, Cardiomyopathies, Signal Transduction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review