Department of Biological and Veterinary Sciences, Faculty of Basic and Preclinical Sciences, Nicolaus Copernicus University, 87-100 Torun, Poland.
Department of Biological and Veterinary Sciences, Faculty of Diagnostic and Clinical Sciences, Nicolaus Copernicus University, 87-100 Torun, Poland.
Nutrients. 2023 Jun 12;15(12):2725. doi: 10.3390/nu15122725.
Atrial fibrillation (AF) is a severe and most common supraventricular arrhythmia in humans, which, if left untreated or treated ineffectively, can lead to ischemic stroke or heart failure. It has been suggested that serum vitamin D (VitD) deficiency may be one of the critical factors influencing the onset of AF, especially in the period after cardiac surgery, such as coronary artery bypass grafting. Several papers have indicated that VitD supplementation reduces the risk of AF, significantly reducing the proportion of patients between the control and study groups in both the pre- and postoperative periods. Factors that increase the risk of AF from VitD deficiency are also further indicated, and these are age, gender, weight, season or comorbidities. In addition, the cardiodepressive mechanism of VitD is not fully understood; however, it is suggested that it acts through at least two pathways. The first indicates a direct effect of VitD on atrial muscle degradation, while the second is related to the modulation of cardiovascular depression factors. Despite many reports showing correlations between no VitD concentrations on the development of AF, this topic is still widely debated and the results from these papers are still subject to doubt. Therefore, this review aims at describing in detail the problem of correlation between VitD deficiency and the development of AF associated mainly with the postoperative period, i.e., after cardiac surgery, especially pathogenesis, and results of this correlation, taking into account recent studies, limitations and future perspectives. Due to the fact that this is still a topical problem, we believe that the collection of the latest reports and a detailed description of the problem is most appropriate in this case.
心房颤动(AF)是人类严重且最常见的室上性心律失常,如果未得到治疗或治疗效果不佳,可能导致缺血性中风或心力衰竭。有人认为血清维生素 D(VitD)缺乏可能是影响 AF 发病的关键因素之一,尤其是在心脏手术后的时期,如冠状动脉旁路移植术。有几篇论文表明,VitD 补充剂可降低 AF 的风险,显著降低对照组和研究组患者在术前和术后的比例。还进一步指出了 VitD 缺乏导致 AF 风险增加的因素,包括年龄、性别、体重、季节或合并症。此外,VitD 的心脏抑制机制尚未完全了解;然而,据推测,它至少通过两种途径发挥作用。第一种途径表明 VitD 对心房肌肉降解有直接作用,而第二种途径与心血管抑制因素的调节有关。尽管有许多报告显示 VitD 浓度与 AF 发展之间存在相关性,但这个话题仍存在广泛争议,这些论文的结果仍然值得怀疑。因此,本综述旨在详细描述 VitD 缺乏与主要与术后时期(即心脏手术后)相关的 AF 发展之间的相关性问题,包括发病机制以及考虑到最近的研究、局限性和未来展望,这方面的相关性的结果。由于这仍然是一个热门话题,我们认为在这种情况下,收集最新的报告并详细描述这个问题是最合适的。