Al-Rubaye Saja, Rodríguez-Mañero Moisés, Ramón González-Juanatey José, Eiras Sonia
Translational Cardiology Group, Health Research Institute, Santiago de Compostela, Spain.
University of Santiago de Compostela, Santiago de Compostela, Spain.
Diabetes Metab Res Rev. 2025 Jul;41(5):e70065. doi: 10.1002/dmrr.70065.
Type 2 diabetes mellitus (T2DM) is present in 25% of patients with atrial fibrillation (AF), the most prevalent arrhythmia in the world. This concomitant disorder enhances thromboembolic events, length of hospital stay after AF ablation, renal impairment after anticoagulation, heart rate variability after glucose-lowering treatment, and cardiac mortality. These patients accumulate inflamed epicardial fat (EAT) with paracrine consequences on β-oxidation of mitochondria, cytosolic Ca fluxes, and sarcomere shortening. Knowing these specific targets will improve the efficacy of personalised preventive and curative therapies since AF leads to AF and EAT accumulation. This review tries to clarify the interplay among epicardial fat accumulation and macrophages with concomitant T2DM and AF to provide a summary of current known mechanisms and therapeutic strategies.
2型糖尿病（T2DM）存在于25%的心房颤动（AF）患者中，心房颤动是全球最常见的心律失常。这种合并症会增加血栓栓塞事件、房颤消融术后住院时间、抗凝后的肾功能损害、降糖治疗后的心率变异性以及心脏死亡率。这些患者会累积发炎的心外膜脂肪（EAT），对线粒体的β氧化、胞质钙通量和肌节缩短产生旁分泌影响。了解这些特定靶点将提高个性化预防和治疗的疗效，因为房颤会导致房颤和EAT累积。本综述试图阐明心外膜脂肪堆积与巨噬细胞之间的相互作用以及合并的T2DM和AF，以总结当前已知的机制和治疗策略。
