Adiposity-associated Atrial Fibrillation: Molecular Determinants, Mechanisms, and Clinical Significance

Overview

Journal Cardiovasc Res

Specialty Cardiology & Vascular Diseases

Date 2022 Jun 11

PMID 35689487

Authors

Monika Gawalko

Arnela Saljic

Na Li

Issam Abu-Taha

Thomas Jespersen

Dominik Linz

Stanley Nattel

Jordi Heijman

Anke Fender

Dobromir Dobrev

Affiliations

Soon will be listed here.

Abstract

Obesity is an important contributing factor to the pathophysiology of atrial fibrillation (AF) and its complications by causing systemic changes, such as altered haemodynamic, increased sympathetic tone, and low-grade chronic inflammatory state. In addition, adipose tissue is a metabolically active organ that comprises various types of fat deposits with discrete composition and localization that show distinct functions. Fatty tissue differentially affects the evolution of AF, with highly secretory active visceral fat surrounding the heart generally having a more potent influence than the rather inert subcutaneous fat. A variety of proinflammatory, profibrotic, and vasoconstrictive mediators are secreted by adipose tissue, particularly originating from cardiac fat, that promote atrial remodelling and increase the susceptibility to AF. In this review, we address the role of obesity-related factors and in particular specific adipose tissue depots in driving AF risk. We discuss the distinct effects of key secreted adipokines from different adipose tissue depots and their participation in cardiac remodelling. The possible mechanistic basis and molecular determinants of adiposity-related AF are discussed, and finally, we highlight important gaps in current knowledge, areas requiring future investigation, and implications for clinical management.

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