Physiology Department, University of Medicine and Pharmacy of Târgu Mureş, Târgu Mureş, Romania; Laboratory of Cardiac Catheterization, Angiography and Electrophysiology, Emergency Institute for Cardiovascular Diseases and Transplantation, Târgu Mureş, Romania.
Physiology Department, University of Medicine and Pharmacy of Târgu Mureş, Târgu Mureş, Romania.
Can J Cardiol. 2018 Nov;34(11):1492-1502. doi: 10.1016/j.cjca.2018.08.018. Epub 2018 Aug 16.
According to estimates, around 5% of the world population has hazel eyes. And there are about as many people with diabetes mellitus (DM). Red hair occurs naturally in up to 2% of the human population. And about as many people are estimated to have atrial fibrillation (AF). If a hazel eyed person with red hair does not surprise us, should a diabetic patient with AF? Accumulating epidemiologic data suggest, however, that the DM-AF association may be more than a simple coincidence. But, how strong is this evidence? Experimental studies bring evidence for a DM-induced atrial proarrhythmic remodelling. But how relevant are these data for the clinical setting? In this review, we aim to provide a critical analysis of the existing clinical and experimental, epidemiologic, and mechanistic data that bridge DM and AF, we emphasize a number of questions that remain to be answered, and we identify hotspots for future research. The therapeutic implications of the DM-AF coexistence are also discussed, with a focus on rhythm control and on conventional and DM-specific upstream therapies for AF management.
据估计，全球约有 5%的人口拥有淡褐色眼睛，而患有糖尿病（DM）的人数也差不多。红发在人类中自然出现的比例高达 2%，大约也有这么多人患有心房颤动（AF）。如果一个拥有淡褐色眼睛和红发的人不会让我们感到惊讶，那么一个患有 AF 的糖尿病患者呢？然而，越来越多的流行病学数据表明，DM-AF 之间的关联不仅仅是偶然的巧合。但是，这种证据有多强？实验研究为 DM 引起的心房促心律失常重塑提供了证据。但是，这些数据对于临床环境有多相关呢？在这篇综述中，我们旨在对 DM 和 AF 之间的现有临床和实验、流行病学和机制数据进行批判性分析，我们强调了一些仍需回答的问题，并确定了未来研究的热点。还讨论了 DM-AF 共存的治疗意义，重点是节律控制以及 AF 管理的传统和 DM 特异性上游治疗。
