Proietti Riccardo, Russo Vincenzo, Wu Maddalena Alessandra, Maggioni Aldo P, Marfella Raffaele
Dipartimento di Cardiologia, Ospedale Luigi Sacco, Milano.
U.O.C. Cardiologia, Seconda Università degli Studi, Ospedale Monaldi, Napoli.
G Ital Cardiol (Rome). 2017 Mar;18(3):199-207. doi: 10.1714/2674.27397.
A large number of studies have linked diabetes mellitus (DM) to the development of cardiovascular disease. However, the association between DM and arrhythmic disease of the heart is less well recognized by the cardiology community. Mostly, the focus is the increased thromboembolic risk that the presence of DM confers to patients with atrial fibrillation (AF). However, recent evidence points toward an increased prevalence of AF in patients with diabetes. This association seems to be reinforced by the presence of additional comorbidities such as hypertension and insulin-resistance. Moreover, different pathophysiological mechanisms support this association. Notably the link between AF and DM is bidirectional: not only patients with DM are more vulnerable to develop AF but also patients with new-onset AF have an increased risk of DM. Herein, the epidemiological findings and pathophysiological mechanisms linking AF and DM will be reviewed in order to increase the knowledge on this association and improve the clinical and therapeutic approach.
大量研究已将糖尿病（DM）与心血管疾病的发生联系起来。然而，心脏病学界对DM与心律失常性心脏病之间的关联认识较少。大多数情况下，关注的焦点是DM的存在赋予房颤（AF）患者的血栓栓塞风险增加。然而，最近的证据表明糖尿病患者中AF的患病率增加。高血压和胰岛素抵抗等其他合并症的存在似乎强化了这种关联。此外，不同的病理生理机制支持这种关联。值得注意的是，AF与DM之间的联系是双向的：不仅DM患者更容易发生AF，而且新发AF患者患DM 的风险也增加。在此，将综述AF与DM之间的流行病学发现和病理生理机制，以增加对这种关联的认识并改进临床和治疗方法。
