CCN2 and atrial fibrillation: Furthermore, Ang II produces transforming growth factor-β1 (TGF-β1), one of the key downstream efforts of Ang II that are secreted from cardiomyocytes and fibroblasts, which is a major factor in promoting fibrosis through the TGF-β1/Smad pathway to mediate the downstream gene product and connective tissue growth factor (CTGF), to increase atrial fibrosis and conduction abnormalities, and to promote AF.