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代谢综合征与心房颤动:不同的实体还是合并症?

Metabolic Syndrome and Atrial Fibrillation: Different Entities or Combined Disorders.

作者信息

Zakynthinos George E, Tsolaki Vasiliki, Oikonomou Evangelos, Vavouranakis Manolis, Siasos Gerasimos, Zakynthinos Epaminondas

机构信息

3rd Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Critical Care Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece.

出版信息

J Pers Med. 2023 Aug 28;13(9):1323. doi: 10.3390/jpm13091323.

Abstract

Obesity, hypertension, insulin resistance, and dyslipidemia are all clusters of an entity called "Metabolic Syndrome". The global trends of this syndrome's incidence/prevalence continue to increase reciprocally, converting it into a massive epidemic problem in the medical community. Observing the risk factors of atrial fibrillation, a medical condition that is also converted to a scourge, almost all parts of the metabolic syndrome are encountered. In addition, several studies demonstrated a robust correlation between metabolic syndrome and the occurrence of atrial fibrillation. For atrial fibrillation to develop, a combination of the appropriate substrate and a trigger point is necessary. The metabolic syndrome affects the left atrium in a multifactorial way, leading to atrial remodeling, thus providing both the substrate and provoking the trigger needed, which possibly plays a substantial role in the progression of atrial fibrillation. Due to the remodeling, treatment of atrial fibrillation may culminate in pernicious sequelae, such as repeated catheter ablation procedures. A holistic approach of the patient, with simultaneous treatment of both entities, is suggested in order to ensure better outcomes for the patients.

摘要

肥胖、高血压、胰岛素抵抗和血脂异常都是名为“代谢综合征”这一实体的聚集表现。该综合征发病率/患病率的全球趋势持续呈相互增长态势,使其在医学界成为一个大规模的流行问题。观察房颤(一种同样也演变成灾祸的病症)的危险因素时,几乎会涉及代谢综合征的所有方面。此外,多项研究表明代谢综合征与房颤的发生之间存在密切关联。房颤的发生需要合适的基质和触发点共同作用。代谢综合征以多因素方式影响左心房,导致心房重构,从而既提供了基质又引发了所需的触发因素,这可能在房颤进展中起重要作用。由于重构,房颤的治疗可能最终导致有害的后遗症,比如反复进行导管消融手术。建议对患者采取整体治疗方法,同时治疗这两种病症,以确保为患者带来更好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/057a/10533132/4154428d9abf/jpm-13-01323-g001.jpg

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