Diabetes mellitus and atrial remodeling: mechanisms and potential upstream therapies

Cardiovasc Ther. 2014 Oct;32(5):233-41. doi: 10.1111/1755-5922.12089.

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, and its prevalence has increasing substantially over the last decades. Recent data suggest that there is an increased risk of AF among the patients with diabetes mellitus (DM). However, the potential molecular mechanisms regarding DM-related AF and diabetic atrial remodeling are not fully understood. In this comprehensive review, we would like to summarize the potential relationship between diabetes and atrial remodeling, including structural, electrical, and autonomic remodeling. Also, some upstream therapies, such as thiazolidinediones, probucol, ACEI/ARBs, may play an important role in the prevention and treatment of AF. Therefore, large prospective randomized, controlled trials and further experimental studies should be challengingly continued.

Keywords: Atrial fibrillation; Atrial remodeling; Diabetes mellitus; Mechanisms; Upstream therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Atrial Fibrillation / drug therapy*
  • Atrial Remodeling / drug effects*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / metabolism
  • Glycated Hemoglobin / analysis
  • Glycation End Products, Advanced / physiology
  • Humans
  • Oxidative Stress
  • PPAR gamma / agonists
  • Probucol / therapeutic use
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic / physiology

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • PPAR gamma
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic
  • hemoglobin A1c protein, human
  • Probucol