Mechanism of and Therapeutic Strategy for Atrial Fibrillation Associated with Diabetes Mellitus

Overview

Journal ScientificWorldJournal

Publisher Wiley

Specialty Biology

Date 2013 Apr 12

PMID 23576900

Citations 10

Authors

Yubi Lin

Hairui Li

Xianwu Lan

Xianghui Chen

Aidong Zhang

Zicheng Li

Affiliations

Soon will be listed here.

Abstract

Diabetes mellitus (DM) is one of the most important risk factors for atrial fibrillation (AF) and is a predictor of stroke and thromboembolism. DM may increase the incidence of AF, and when it is combined with other risk factors, the incidence of stroke and thromboembolism may also be higher; furthermore, hospitalization due to heart failure appears to increase. Maintenance of well-controlled blood glucose and low levels of HbA1c in accordance with guidelines may decrease the incidence of AF. The mechanisms of AF associated with DM are autonomic remodeling, electrical remodeling, structural remodeling, and insulin resistance. Inhibition of the renin-angiotensin system is suggested to be an upstream therapy for this type of AF. Studies have indicated that catheter ablation may be effective for AF associated with DM, restoring sinus rhythm and improving prognosis. Catheter ablation combined with hypoglycemic agents may further increase the rate of maintenance of sinus rhythm and reduce the need for reablation.

Citing Articles

Insulin Treatment Reduces Susceptibility to Atrial Fibrillation in Type 1 Diabetic Mice.

Maria Z, Campolo A, Scherlag B, Ritchey J, Lacombe V Front Cardiovasc Med. 2020; 7:134.

PMID: 32903422 PMC: 7434932. DOI: 10.3389/fcvm.2020.00134.

Impact of Diabetes Mellitus on Stroke and Survival in Patients With Atrial Fibrillation.

Patlolla S, Lee H, Noseworthy P, Wysokinski W, Hodge D, Greene E Am J Cardiol. 2020; 131:33-39.

PMID: 32723556 PMC: 7484039. DOI: 10.1016/j.amjcard.2020.06.049.

The association between SGLT2 inhibitors and new-onset arrhythmias: a nationwide population-based longitudinal cohort study.

Chen H, Huang J, Siao W, Jong G Cardiovasc Diabetol. 2020; 19(1):73.

PMID: 32503541 PMC: 7275510. DOI: 10.1186/s12933-020-01048-x.

Loss of insulin signaling may contribute to atrial fibrillation and atrial electrical remodeling in type 1 diabetes.

Polina I, Jansen H, Li T, Moghtadaei M, Bohne L, Liu Y Proc Natl Acad Sci U S A. 2020; 117(14):7990-8000.

PMID: 32198206 PMC: 7148583. DOI: 10.1073/pnas.1914853117.

Cardiometabolic-Based Chronic Disease, Addressing Knowledge and Clinical Practice Gaps: JACC State-of-the-Art Review.

Mechanick J, Farkouh M, Newman J, Garvey W J Am Coll Cardiol. 2020; 75(5):539-555.

PMID: 32029137 PMC: 8168371. DOI: 10.1016/j.jacc.2019.11.046.

References

De Mello W . Intracellular angiotensin II regulates the inward calcium current in cardiac myocytes. Hypertension. 1998; 32(6):976-82. DOI: 10.1161/01.hyp.32.6.976. View

Karabag T, Aydin M, Dogan S, Cetiner M, Sayin M, Gudul N . Prolonged P wave dispersion in pre-diabetic patients. Kardiol Pol. 2011; 69(6):566-71. View

Urbancic-Rovan V, Meglic B, Stefanovska A, Bernjak A, Azman-Juvan K, Kocijancic A . Incipient cardiovascular autonomic imbalance revealed by wavelet analysis of heart rate variability in Type 2 diabetic patients. Diabet Med. 2007; 24(1):18-26. DOI: 10.1111/j.1464-5491.2007.02019.x. View

Mitasikova M, Lin H, Soukup T, Imanaga I, Tribulova N . Diabetes and thyroid hormones affect connexin-43 and PKC-epsilon expression in rat heart atria. Physiol Res. 2008; 58(2):211-217. DOI: 10.33549/physiolres.931425. View

Fogari R, Zoppi A, Mugellini A, Corradi L, Lazzari P, Preti P . Comparative evaluation of effect of valsartan/amlodipine and atenolol/amlodipine combinations on atrial fibrillation recurrence in hypertensive patients with type 2 diabetes mellitus. J Cardiovasc Pharmacol. 2008; 51(3):217-22. DOI: 10.1097/FJC.0b013e318160b42a. View

Caballero R, Delpon E, Valenzuela C, Longobardo M, Tamargo J . Losartan and its metabolite E3174 modify cardiac delayed rectifier K(+) currents. Circulation. 2000; 101(10):1199-205. DOI: 10.1161/01.cir.101.10.1199. View

Lip G, Varughese G . Diabetes mellitus and atrial fibrillation: perspectives on epidemiological and pathophysiological links. Int J Cardiol. 2005; 105(3):319-21. DOI: 10.1016/j.ijcard.2005.03.003. View

Voulgari C, Psallas M, Kokkinos A, Argiana V, Katsilambros N, Tentolouris N . The association between cardiac autonomic neuropathy with metabolic and other factors in subjects with type 1 and type 2 diabetes. J Diabetes Complications. 2010; 25(3):159-67. DOI: 10.1016/j.jdiacomp.2010.06.001. View

Sugishita K, Shiono E, Sugiyama T, Ashida T . Diabetes influences the cardiac symptoms related to atrial fibrillation. Circ J. 2003; 67(10):835-8. DOI: 10.1253/circj.67.835. View

10.

Fareh S, Benardeau A, Thibault B, Nattel S . The T-type Ca(2+) channel blocker mibefradil prevents the development of a substrate for atrial fibrillation by tachycardia-induced atrial remodeling in dogs. Circulation. 1999; 100(21):2191-7. DOI: 10.1161/01.cir.100.21.2191. View

11.

Forleo G, Mantica M, De Luca L, Leo R, Santini L, Panigada S . Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. J Cardiovasc Electrophysiol. 2008; 20(1):22-8. DOI: 10.1111/j.1540-8167.2008.01275.x. View

12.

Guazzi M, Belletti S, Bianco E, Lenatti L, Guazzi M . Endothelial dysfunction and exercise performance in lone atrial fibrillation or associated with hypertension or diabetes: different results with cardioversion. Am J Physiol Heart Circ Physiol. 2006; 291(2):H921-8. DOI: 10.1152/ajpheart.00986.2005. View

13.

Guazzi M, Belletti S, Lenatti L, Bianco E, Guazzi M . Effects of cardioversion of atrial fibrillation on endothelial function in hypertension or diabetes. Eur J Clin Invest. 2006; 37(1):26-34. DOI: 10.1111/j.1365-2362.2007.01744.x. View

14.

Kennedy W, Navarro X, Sutherland D . Neuropathy profile of diabetic patients in a pancreas transplantation program. Neurology. 1995; 45(4):773-80. DOI: 10.1212/wnl.45.4.773. View

15.

Dublin S, Glazer N, Smith N, Psaty B, Lumley T, Wiggins K . Diabetes mellitus, glycemic control, and risk of atrial fibrillation. J Gen Intern Med. 2010; 25(8):853-8. PMC: 2896589. DOI: 10.1007/s11606-010-1340-y. View

16.

Pop-Busui R . Cardiac autonomic neuropathy in diabetes: a clinical perspective. Diabetes Care. 2010; 33(2):434-41. PMC: 2809298. DOI: 10.2337/dc09-1294. View

17.

Kume O, Takahashi N, Wakisaka O, Nagano-Torigoe Y, Teshima Y, Nakagawa M . Pioglitazone attenuates inflammatory atrial fibrosis and vulnerability to atrial fibrillation induced by pressure overload in rats. Heart Rhythm. 2010; 8(2):278-85. DOI: 10.1016/j.hrthm.2010.10.029. View

18.

Ziegler D, Dannehl K, Muhlen H, Spuler M, Gries F . Prevalence of cardiovascular autonomic dysfunction assessed by spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses at various stages of diabetic neuropathy. Diabet Med. 1992; 9(9):806-14. DOI: 10.1111/j.1464-5491.1992.tb01898.x. View

19.

Li G, Liu T . The therapeutic strategies of enhancing adiponectin and lowering leptin may be benefit to controlling atrial fibrillation. Med Hypotheses. 2009; 73(1):122. DOI: 10.1016/j.mehy.2009.02.005. View

20.

Huxley R, Filion K, Konety S, Alonso A . Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. Am J Cardiol. 2011; 108(1):56-62. PMC: 3181495. DOI: 10.1016/j.amjcard.2011.03.004. View