Mauriello Alfredo, Correra Adriana, Maratea Anna Chiara, Caturano Alfredo, Liccardo Biagio, Perrone Marco Alfonso, Giordano Antonio, Nigro Gerardo, D'Andrea Antonello, Russo Vincenzo
Cardiology Unit, Department of Medical and Translational Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, 80131 Naples, Italy.
Cardiology and Intensive Care Unit, Department of Cardiology, "Umberto I" Hospital, 84014 Nocera Inferiore, Italy.
J Clin Med. 2025 Feb 28;14(5):1652. doi: 10.3390/jcm14051652.
Dyslipidemia is a metabolic disorder characterized by quantitative and/or qualitative abnormalities in serum lipid levels. Elevated serum cholesterol levels can modify the turnover and recruitment of ionic channels in myocytes and cellular homeostasis, including those of inflammatory cells. Experimental and clinical data indicate that inflammation is implicated in the pathophysiology of atrial remodeling, which is the substrate of atrial fibrillation (AF). Data about the association between increased lipid serum levels and AF are few and contrasting. Lipoprotein (a), adiposity, and inflammation seem to be the main drivers of AF; in contrast, low-density lipoproteins, high-density lipoproteins and triglycerides are not directly involved in AF onset. The present review aimed to describe the pathophysiological link between dyslipidemia and AF, the efficacy of lipid-lowering therapies in atherosclerotic cardiovascular disease (ASCVD) patients with and without AF, and the impact of lipid-lowering therapies on AF incidence.
血脂异常是一种代谢紊乱，其特征是血清脂质水平存在定量和/或定性异常。血清胆固醇水平升高可改变心肌细胞中离子通道的周转和募集以及细胞内稳态，包括炎症细胞的离子通道。实验和临床数据表明，炎症与心房重构的病理生理学有关，心房重构是心房颤动（AF）的基础。关于血清脂质水平升高与AF之间关联的数据很少且相互矛盾。脂蛋白（a）、肥胖和炎症似乎是AF的主要驱动因素；相比之下，低密度脂蛋白、高密度脂蛋白和甘油三酯并不直接参与AF的发生。本综述旨在描述血脂异常与AF之间的病理生理联系、降脂治疗对有或没有AF的动脉粥样硬化性心血管疾病（ASCVD）患者的疗效，以及降脂治疗对AF发生率的影响。
