Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death

被引:43
作者
Homan, Edwin A. [1 ]
Reyes, Michael V. [1 ]
Hickey, Kathleen T. [1 ]
Morrow, John P. [1 ]
机构
[1] Columbia Univ, Med Ctr, New York, NY 10027 USA
关键词
atrial fibrillation; obesity-complications; sudden cardiac death (SCD); diabetes mellitus; arrhythmia (heart rhythm disorders); OBSTRUCTIVE SLEEP-APNEA; LEFT-VENTRICULAR MASS; INDEPENDENT RISK; ALL-CAUSE; PROGNOSTIC-SIGNIFICANCE; ATHEROSCLEROSIS RISK; CARDIOVASCULAR RISK; CATHETER ABLATION; BARIATRIC SURGERY; OXIDATIVE STRESS;
D O I
10.3389/fphys.2018.01847
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
The epidemics of obesity and diabetes mellitus are associated with an increased incidence of both atrial fibrillation (AF), the most common sustained arrhythmia in adults, and sudden cardiac death (SCD). Obesity and DM are known to have adverse effects on cardiac structure and function. The pathologic mechanisms are thought to involve cardiac tissue remodeling, metabolic dysregulation, inflammation, and oxidative stress. Clinical data suggest that left atrial size, epicardial fat pad thickness, and other modifiable risk factors such as hypertension, glycemic control, and obstructive sleep apnea may mediate the association with AF. Data from human atrial tissue biopsies demonstrate alterations in atrial lipid content and evidence of mitochondrial dysfunction. With respect to ventricular arrhythmias, abnormalities such as long QT syndrome, frequent premature ventricular contractions, and left ventricular hypertrophy with diastolic dysfunction are commonly observed in obese and diabetic humans. The increased risk of SCD in this population may also be related to excessive cardiac lipid deposition and insulin resistance. While nutritional interventions have had limited success, perhaps due to poor long-term compliance, weight loss and improved cardiorespiratory fitness may reduce the frequency and severity of AF.
引用
收藏
页数:13
相关论文
共 123 条
[1]   Effect of Weight Reduction and Cardiometabolic Risk Factor Management on Symptom Burden and Severity in Patients With Atrial Fibrillation A Randomized Clinical Trial [J].
Abed, Hany S. ;
Wittert, Gary A. ;
Leong, Darryl P. ;
Shirazi, Masoumeh G. ;
Bahrami, Bobak ;
Middeldorp, Melissa E. ;
Lorimer, Michelle F. ;
Lau, Dennis H. ;
Antic, Nicholas A. ;
Brooks, Anthony G. ;
Abhayaratna, Walter P. ;
Kalman, Jonathan M. ;
Sanders, Prashanthan .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (19) :2050-2060
[2]   Obesity results in progressive atrial structural and electrical remodeling: Implications for atrial fibrillation [J].
Abed, Hany S. ;
Samuel, Chrishan S. ;
Lau, Dennis H. ;
Kelly, Darren J. ;
Royce, Simon G. ;
Alasady, Muayad ;
Mahajan, Rajiv ;
Kuklik, Pawel ;
Zhang, Yuan ;
Brooks, Anthony G. ;
Nelson, Adam J. ;
Worthley, Stephen G. ;
Abhayaratna, Walter P. ;
Kalman, Jonathan M. ;
Wittert, Gary A. ;
Sanders, Prashanthan .
HEART RHYTHM, 2013, 10 (01) :90-100
[3]   Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study [J].
Adabag, Selcuk ;
Huxley, Rachel R. ;
Lopez, Faye L. ;
Chen, Lin Y. ;
Sotoodehnia, Nona ;
Siscovick, David ;
Deo, Rajat ;
Konety, Suma ;
Alonso, Alvaro ;
Folsom, Aaron R. .
HEART, 2015, 101 (03) :215-221
[4]   The mitochondrial origin of postischernic arrhythmias [J].
Akar, FG ;
Aon, MA ;
Tomaselli, GF ;
O'Rourke, B .
JOURNAL OF CLINICAL INVESTIGATION, 2005, 115 (12) :3527-3535
[5]   Impact of new-onset diabetes mellitus on development of atrial fibrillation and heart failure in high-risk hypertension (from the VALUE trial) [J].
Aksnes, Tonje Amb ;
Schmieder, Roland E. ;
Kjeldsen, Sverre Erik ;
Ghani, Sajda ;
Hua, Tsushung Augie ;
Julius, Stevo .
AMERICAN JOURNAL OF CARDIOLOGY, 2008, 101 (05) :634-638
[6]   Simple Risk Model Predicts Incidence of Atrial Fibrillation in a Racially and Geographically Diverse Population: the CHARGE-AF Consortium [J].
Alonso, Alvaro ;
Krijthe, Bouwe P. ;
Aspelund, Thor ;
Stepas, Katherine A. ;
Pencina, Michael J. ;
Moser, Carlee B. ;
Sinner, Moritz F. ;
Sotoodehnia, Nona ;
Fontes, Joao D. ;
Janssens, A. Cecile J. W. ;
Kronmal, Richard A. ;
Magnani, Jared W. ;
Witteman, Jacqueline C. ;
Chamberlain, Alanna M. ;
Lubitz, Steven A. ;
Schnabel, Renate B. ;
Agarwal, Sunil K. ;
McManus, David D. ;
Ellinor, Patrick T. ;
Larson, Martin G. ;
Burke, Gregory L. ;
Launer, Lenore J. ;
Hofman, Albert ;
Levy, Daniel ;
Gottdiener, John S. ;
Kaeaeb, Stefan ;
Couper, David ;
Harris, Tamara B. ;
Soliman, Elsayed Z. ;
Stricker, Bruno H. C. ;
Gudnason, Vilmundur ;
Heckbert, Susan R. ;
Benjamin, Emelia J. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2013, 2 (02) :e000102
[7]  
Alvarez VB, 1999, REV ESP CARDIOL, V52, P403
[8]   Diabetes and new-onset atrial fibrillation in a hypertensive population [J].
Alves-Cabratosa, Lia ;
Garcia-Gil, Maria ;
Comas-Cufi, Marc ;
Marti, Ruth ;
Ponjoan, Anna ;
Parramon, Didac ;
Blanch, Jordi ;
Ramos, Rafel .
ANNALS OF MEDICINE, 2016, 48 (03) :119-127
[9]   Diabetes mellitus, blood glucose and the risk of atrial fibrillation: A systematic review and meta-analysis of cohort studies [J].
Aune, Dagfinn ;
Feng, Tingting ;
Schlesinger, Sabrina ;
Janszky, Imre ;
Norat, Teresa ;
Riboli, Elio .
JOURNAL OF DIABETES AND ITS COMPLICATIONS, 2018, 32 (05) :501-511
[10]   Atrial fibrillation in an African-American cohort: The Jackson Heart Study [J].
Austin, Thomas R. ;
Wiggins, Kerri L. ;
Blackshear, Chad ;
Yang, Yi ;
Benjamin, Emelia J. ;
Curtis, Lesley H. ;
Sotoodehnia, Nona ;
Correa, Adolfo ;
Heckbert, Susan R. .
CLINICAL CARDIOLOGY, 2018, 41 (08) :1049-1054