Kantharia Bharat K, Tabary Mohammadreza, Wu Lingling, Wang Xinyu, Narasimhan Bharat, Linz Dominik, Heijman Jordi, Wehrens Xander H T
Cardiovascular and Heart Rhythm Consultants, New York, New York, USA.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Cardiovasc Electrophysiol. 2025 Apr 1. doi: 10.1111/jce.16655.
In spite of significant progress made in the management in recent decades, atrial fibrillation (AF) continues to cause increased mortality and significant morbidities, including heart failure and stroke. Diabetes mellitus (DM) is an independent risk factor for AF, and adds risks to increased mortality and hospitalizations when present along with AF. The pathophysiology of AF related to DM is complex with many inter-related factors. Atrial cardiomyopathy (atriopathy) related to structural changes from subcellular abnormalities and fibrosis, coupled with cardiac mechanical dysfunction, abnormal ion expression, dysregulation of the renin-angiotensin-aldosterone system and the autonomic nervous system function, play crucial roles in genesis and progression of AF. In this review, we discuss insights from basic to translational science into the mechanisms and management related to AF associated with DM.
尽管近几十年来在房颤管理方面取得了显著进展，但房颤仍然导致死亡率上升和包括心力衰竭和中风在内的严重发病率。糖尿病是房颤的一个独立危险因素，与房颤并存时会增加死亡和住院风险。与糖尿病相关的房颤病理生理学复杂，涉及许多相互关联的因素。与亚细胞异常和纤维化导致的结构变化相关的心房心肌病（心房病变），再加上心脏机械功能障碍、离子表达异常、肾素-血管紧张素-醛固酮系统失调以及自主神经系统功能紊乱，在房颤的发生和发展中起着关键作用。在本综述中，我们讨论了从基础科学到转化科学对与糖尿病相关的房颤的机制和管理的见解。
