The Role of Different Components of Metabolic Syndrome in the Pathogenesis of Atrial Fibrillation
DOI:
https://doi.org/10.24207/jca.v37i1.3501Abstract
Metabolic syndrome (MetS) goes by various aliases such as dysmetabolic syndrome, syndrome X, and insulin resistance syndrome. Dysmetabolic syndromes indicate factors that pose risks for the onset of cardiovascular diseases and type 2 diabetes, making it a rapidly escalating global health concern. Atrial Fibrillation (AF) disrupts the heart’s electrical system, manifesting as dysrhythmias and arrhythmias with irregular heartbeats. This condition significantly amplifies worldwide mortality and morbidity rates. The principal hazard associated with metabolic syndrome is cardiovascular disease. Notably, metabolic syndrome plays a pivotal role in the genesis of AF, as numerous studies have highlighted the fundamental connection between the two. This review underscores that the distinct components of metabolic syndrome – hypertension, diabetes, obesity, and dyslipidemia – actively participate in the pathophysiology of AF development and progression through atrial remodeling, involving both structural and electrical modifications.
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Vijaya KV. Chronic Disease and Polycystic Ovary Syndrome: Are they Related. JWomen’s Health Care. 2012;1:e101. https://doi.org/10.4172/2167-0420.1000e101 DOI: https://doi.org/10.4172/2167-0420.1000e101
Andrade J, Khairy P, Dobrev D, Nattel S. The clinical profile and pathophysiologyof atrial fibrillation: relationships among clinical features, epidemiology, andmechanisms. Circulation research, 2014;114(9):1453 1468. https://doi.org/10.1161/circresaha.114.303211 DOI: https://doi.org/10.1161/CIRCRESAHA.114.303211
Kaur J. A comprehensive review on metabolic syndrome. Cardiology research andpractice 2014:2014:943162. https://doi.org/10.1155/2014/943162 DOI: https://doi.org/10.1155/2014/943162
Alberti KGMM, Zimmet P, Shaw J.Metabolic syndrome—a new world- wide definition. A consensus statement from the international diabetes federation. Diabetic medicine. 2006;23(5):469-480. https://doi.org/10.1111/j.1464-5491.2006.01858.x DOI: https://doi.org/10.1111/j.1464-5491.2006.01858.x
Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(7):e257-354. https://doi.org/10.1161/circulationaha.106.177292 DOI: https://doi.org/10.1093/eurheartj/ehm315
Lévy S. Classification system of atrial fibrillation. Current Opinion in Cardiology. 2000;15(1):54–7. https://doi.org/10.1097/00001573-200001000-00007 DOI: https://doi.org/10.1097/00001573-200001000-00007
Guzzardi MA, Iozzo P. Fatty heart, cardiac damage, and inflammation. Rev DiabetStud. 2011;8(3):403 417.https://doi.org/10.1900/rds.2011.8.403 DOI: https://doi.org/10.1900/RDS.2011.8.403
Grundy SM, Brewer JHB, Cleeman JI, Smith Jr SC, Lenfant C; American Heart Association, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433-438. https://doi.org/10.1161/01.cir.0000111245.75752.c6 DOI: https://doi.org/10.1161/01.CIR.0000111245.75752.C6
Wang TJ, Parise H, Levy D, D’Agostino RB, Wolf PA, Vasan RS, et al. Obesity and the risk of new-onset atrial fibrillation. Jama. 2004;292(20):2471-2477.https://doi.org/10.1001/jama.292.20.2471 DOI: https://doi.org/10.1001/jama.292.20.2471
Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;56(14):1113-32. https://doi.org/10.1016/j.jacc.2010.05.034 DOI: https://doi.org/10.1016/j.jacc.2010.05.034
Wanahita N, Messerli FH, Bangalore S, Gami AS, Somers VK, Steinberg JS. Atrial fibrillation and obesity results of a meta-analysis. American heart journal. 2008;155(2):310-315. https://doi.org/10.1016/j.ahj.2007.10.004 DOI: https://doi.org/10.1016/j.ahj.2007.10.004
Tadic M, Ivanovic B, Cuspidi, C. What do we currently know about metabolic syndrome and atrial fibrillation? Clinical cardiology. 2013;36(11):654-662. https://doi.org/10.1002/clc.22163 DOI: https://doi.org/10.1002/clc.22163
Carr MC, Brunzell JD. Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk. The journal of clinical endocrinology & metabolism. 2004;89(6):2601-2607. https://doi.org/10.1210/jc.2004-0432 DOI: https://doi.org/10.1210/jc.2004-0432
Li ZZ, Du X, Guo XY, Tang RB, Jiang C, Liu N, et al. Association between blood lipid profiles and atrial fibrillation: a case-control study. Medical science monitor: international medical journal of experimental and clinical research. 2018;24:3903. https://doi.org/10.12659/msm.907580 DOI: https://doi.org/10.12659/MSM.907580
Taegtmeyer H, McNulty P, Young ME. Adaptation and maladaptation of the heart in diabetes: Part I: general concepts. Circulation. 2002;105(14):1727-1733.https://doi.org/10.1161/01.cir.0000012466.50373.e8 DOI: https://doi.org/10.1161/01.CIR.0000012466.50373.E8
Iozzo P, Lautamaki R, Borra R, Lehto HR, Bucci M, Viljanen A, et al. Contribution of glucose tolerance and gender to cardiac adiposity. The Journal of Clinical Endocrinology & Metabolism. 2009;94(11):4472-4482. https://doi.org/10.1210/jc.2009-0436
Szczepaniak LS, Dobbins RL, Metzger GJ, Sartoni- D’Ambrosia G, Arbique D, Vongpatanasin W, et al. Myocardial triglycerides and systolic function in humans: in vivo evaluation by localized proton spectroscopy and cardiac imaging. Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine. 2003;49(3):417-423. https://doi.org/10.1002/mrm.10372 DOI: https://doi.org/10.1002/mrm.10372
Taguchi R, Takasu J, Itani Y, Yamamoto R, Yokoyama K, Watanabe S, et al. Pericardial fat accumulation in men as a risk factor for coronary artery disease. Atherosclerosis. 2001;57(1):203-209. https://doi.org/10.1016/s0021-9150(00)00709-7 DOI: https://doi.org/10.1016/S0021-9150(00)00709-7
Sacks HS, Fain JN. Human epicardial adipose tissue: a review. American heart journal, 2007;153(6):907 917. https://doi.org/10.1016/j.ahj.2007.03.019 DOI: https://doi.org/10.1016/j.ahj.2007.03.019
Iozzo P, Lautamaki R, Borra R, Lehto HR, Bucci M, Viljanen A, et al. Contribution of glucose tolerance and gender to cardiac adiposity. The Journal of Clinical Endocrinology & Metabolism. 2020;94(11):4472-4482. https://doi.org/10.1210/jc.2009-0436 DOI: https://doi.org/10.1210/jc.2009-0436
Hammer S, van der Meer RW, Lamb HJ, de Boer HH, Bax JJ, de Roos A, et al. Short-term flexibility of myocardial triglycerides and diastolic function in patients with type 2 diabetes mellitus. American Journal of Physiology-Endocrinology and Metabolism. 2008;295(3):E714-E718. https://doi.org/10.1152/ajpendo.90413.2008 DOI: https://doi.org/10.1152/ajpendo.90413.2008
Ye J. Mechanisms of insulin resistance in obesity. Frontiers of medicine. 2013;7(1):14-24. https://doi.org/10.1007/s11684-013-0262-6 DOI: https://doi.org/10.1007/s11684-013-0262-6
Iozzo P. Myocardial, perivascular, and epicardial fat. Diabetes care. 2011;34(Supplement 2):S371-S379. https://doi.org/10.2337/dc11-s250 DOI: https://doi.org/10.2337/dc11-s250
Balse E, El-Haou S, Dillanian G, Dauphin A, Eldstrom J, Fedida D, et al. Cholesterol modulates the recruitment of Kv1. 5 channels from Rab11-associated recycling endosome in native atrial myocytes. Proceedings of the National Academy of Sciences. 2009;106(34):14681-14686. https://doi.org/10.1073/pnas.0902809106 DOI: https://doi.org/10.1073/pnas.0902809106
Mozos I. Arrhythmia risk and obesity. Journal of Molecular and Genetic Medicine. 2014 [Accessed Dec. 17, 2017]:1747- 0862. Available at: https://www.researchgate.net/profile/Ioana-Mozos/publication/260287137_Arrhythmia_Risk_and_Obesity/links/02e7e5308622390d3d000000/Arrhythmia-Risk-and-Obesity.pdf
Mozos I. Chronic myocardial infarction. Influence of obesity on dispersion parameters. Timisoara Medical Journal. 2005;55(3):272-275. Avaialble at: https://www.hilarispublisher.com/open-access/arrhythmia-risk and-obesity-1747-0862.S1-006.pdf
Shimano M, Shibata R, Tsuji Y, Kamiya H, Uchikawa T, Harata S, et al. Circulating adiponectin levels in patients with atrial fibrillation. Circ J. 2008;72(7):1120-1124.https://doi.org/10.1253/circj.72.1120 DOI: https://doi.org/10.1253/circj.72.1120
Lin YK, Chen YC, Chang SL, Lin YJ, Chen JH, Yeh YH, et al. Heart failure epicardial fat increases atrialarrhythmogenesis. Int J Cardiol. 2013;167(5):1979-1983.https://doi.org/10.1016/j.ijcard.2012.05.009 DOI: https://doi.org/10.1016/j.ijcard.2012.05.009
Lin YK, Chen YC, Chen JH, Chen SA, Chen YJ. Adipocytes modulate the electrophysiology of atrial myocytes: implications in obesityinduced atrial fibrillation. Basic Res Cardiol. 2012;107(5):293. https://doi.org/10.1007/s00395-012-0293-1 DOI: https://doi.org/10.1007/s00395-012-0293-1
Nagashima K, Nakahara S, Okumura Y, Mano H, Sonoda K, Kogawa R, et al. Termination of atrial fibrillation by ablation of highdominant frequency sites adjacent to epicardial adipose tissue. Journal of Arrhythmia. 2013;29(4):242-243. https://doi.org/10.1016/j.joa.2012.10.004 DOI: https://doi.org/10.1016/j.joa.2012.10.004
Hung CL, Chao TF, Lai YH, Yen CH, Wang KL, Tsao HM, et al. The relationship among atrium electromechanical interval, insulin resistance, and metabolic syndrome. Canadian Journal of Cardiology. 2013;29(10):1263-1268. https://doi.org/10.1016/j.cjca.2013.01.001 DOI: https://doi.org/10.1016/j.cjca.2013.01.001
Lalani AP, Kanna B, John J, Ferrick KJ, Huber MS, Shapiro LE. Abnormal signal-averaged electrocardiogram (SAECG) in obesity. Obesity research. 2000;8(1):20-28. https://doi.org/10.1038/oby.2000.4 DOI: https://doi.org/10.1038/oby.2000.4
Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH. Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. Circulation Research (Review). 2017;120(9):1501–17. https://doi.org/10.1161/circresaha.117.309732 DOI: https://doi.org/10.1161/CIRCRESAHA.117.309732
Nalliah CJ, Sanders P, Kottkamp H, Kalman JM. The role of obesity in atrial fibrillation. European heart journal. 2016;37(20):1565-1572.https://doi.org/10.1093/eurheartj/ehv486 DOI: https://doi.org/10.1093/eurheartj/ehv486
Verdecchia P, Angeli F, Reboldi G. Hypertension and atrial fibrillation: doubts and certainties from basic and clinical studies. Circ Res. 2018;122:352–68. https://doi.org/10.1161/circresaha.117.311402 DOI: https://doi.org/10.1161/CIRCRESAHA.117.311402
Goette A, Staack T, Röcken C, Arndt M, Geller JC, Huth C, et al. Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. Journal of the American College of Cardiology. 2000;35(6):1669-1677.https://doi.org/10.1016/s0735-1097(00)00611-2 DOI: https://doi.org/10.1016/S0735-1097(00)00611-2
Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a populationbased cohort: the Framingham Heart Study. Jama, 1994;271(11):840-844. https://doi.org/10.1001/jama.1994.03510350050036 DOI: https://doi.org/10.1001/jama.271.11.840
Iwasaki YK, Nishida K, Kato T, Nattel S. Atrial fibrillation pathophysiology: implications for management. Circulation. 2011;124(20):2264-74.https://doi.org/10.1161/circulationaha.111.019893 DOI: https://doi.org/10.1161/CIRCULATIONAHA.111.019893
Cuspidi C, Negri F, Lonati L, Muiesan ML, Capra A, Milan A, et al. Working Group on Heart and Hypertension of the Italian Society of Hypertension. Prevalence and correlates of echocardiographic left atrial enlargement in hypertensive outpatients in clinical practice. Clinical and Experimental Hypertension. 2011;33(5):328-35.https://doi.org/10.3109/10641963.2010.549265 DOI: https://doi.org/10.3109/10641963.2010.549265
Byrd GD, Prasad SM, Ripplinger CM, Cassilly TR, Schuessler RB, Boineau JP, et al. Importance of geometry and refractory period in sustaining atrial fibrillation: testing the critical mass hypothesis. Circulation. 2005;112(9Suppl):I-7-13. https://doi.org/10.1161/circulationaha.104.526210 DOI: https://doi.org/10.1161/CIRCULATIONAHA.104.526210
Dzeshka MS, Shantsila A, Shantsila E, Lip GY. Atrial fibrillation and hypertension. Hypertension. 2017;70(5):854-61.https://doi.org/10.1161/hypertensionaha.117.08934 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.117.08934
Piccini JP, Granger CB. Insulin therapy and stroke risk in patients with diabetes and atrial fibrillation: guilty by association. 2017;69(4):420-422.https://doi.org/10.1016/j.jacc.2016.11.030 DOI: https://doi.org/10.1016/j.jacc.2016.11.030
Nichols GA, Reinier K, Chugh SS. Independent contribution of diabetes to increased prevalence and incidence of atrial fibrillation. Diabetes care. 2009;32(10):1851-6.https://doi.org/10.2337/dc09-0939 DOI: https://doi.org/10.2337/dc09-0939
Lind L, Berne C, Andren B, Lithell H. Relationship between diastolic hypertension and myocardial morphology and function in elderly males with diabetes mellitus. Diabetologia. 1996;39(12):1603-6. https://doi.org/10.1007/s001250050621 DOI: https://doi.org/10.1007/s001250050621
Kato T, Yamashita T, Sekiguchi A, Tsuneda T, Sagara K, Takamura M, et al. AGEs- RAGE system mediates atrial structural remodeling in the diabetic rat. Journal of cardiovascular electrophysiology. 2008;19(4):415-20. https://doi.org/10.1111/j.1540-8167.2007.01037.x DOI: https://doi.org/10.1111/j.1540-8167.2007.01037.x
Johnson LS, Juhlin T, Engström G, Nilsson PM. Low fasting plasma insulin is associated with atrial fibrillation in men from a cohort study-the Malmö preventive project. BMC cardiovascular disorders. 2014;14:107. https://doi.org/10.1186/1471-2261-14-107 DOI: https://doi.org/10.1186/1471-2261-14-107
Wang A, Green JB, Halperin JL, Piccini JP. Atrial fibrillation and diabetes mellitus: JACC review topic of the week. Journal of the American College of Cardiology. 2019;74(8):1107-15. https://doi.org/10.1016/j.jacc.2019.07.020 DOI: https://doi.org/10.1016/j.jacc.2019.07.020
