Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (M.K.C., S.Y.W.).
Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Germany (O.H.).
Circ Res. 2024 Apr 12;134(8):1029-1045. doi: 10.1161/CIRCRESAHA.123.323477. Epub 2024 Apr 11.
There has been increased awareness of the linkage between environmental exposures and cardiovascular health and disease. Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting millions of people worldwide and contributing to substantial morbidity and mortality. Although numerous studies have explored the role of genetic and lifestyle factors in the development and progression of atrial fibrillation, the potential impact of environmental determinants on this prevalent condition has received comparatively less attention. This review aims to provide a comprehensive overview of the current evidence on environmental determinants of atrial fibrillation, encompassing factors such as air pollution, temperature, humidity, and other meteorologic conditions, noise pollution, greenspace, and the social environment. We discuss the existing evidence from epidemiological and mechanistic studies, critically evaluating the strengths and limitations of these investigations and the potential underlying biological mechanisms through which environmental exposures may affect atrial fibrillation risk. Furthermore, we address the potential implications of these findings for public health and clinical practice and identify knowledge gaps and future research directions in this emerging field.
人们越来越意识到环境暴露与心血管健康和疾病之间存在关联。心房颤动是最常见的持续性心律失常，影响着全球数以百万计的人，并导致大量的发病率和死亡率。尽管许多研究已经探讨了遗传和生活方式因素在心房颤动的发展和进展中的作用，但环境决定因素对这种普遍疾病的潜在影响相对较少受到关注。本综述旨在提供一个关于心房颤动的环境决定因素的综合概述，包括空气污染、温度、湿度和其他气象条件、噪声污染、绿地和社会环境等因素。我们讨论了来自流行病学和机制研究的现有证据，批判性地评估了这些研究的优缺点以及环境暴露可能影响心房颤动风险的潜在生物学机制。此外，我们还讨论了这些发现对公共卫生和临床实践的潜在影响，并确定了这个新兴领域的知识空白和未来的研究方向。
