What Do We Currently Know About Metabolic Syndrome and Atrial Fibrillation?

Abstract

Metabolic syndrome represents a cluster of atherogenic risk factors including hypertension, insulin resistance, obesity, and dyslipidemia. Considering that all of these risk factors could influence the development of atrial fibrillation, an association between atrial fibrillation and the metabolic syndrome has been suggested. Additionally, oxidative stress and inflammation have been involved in the pathogenesis of both metabolic syndrome and atrial fibrillation. The mechanisms that relate metabolic syndrome to the increased risk of atrial fibrillation occurrence are not completely understood. Metabolic syndrome and atrial fibrillation are associated with increased cardiovascular morbidity and mortality. Because atrial fibrillation is the most common arrhythmia, and along with the prevalence of metabolic syndrome constantly increasing, it would be very important to determine the relationship between these 2 entities, especially due to the fact that the risk factors of metabolic syndrome are mainly correctable. This review focused on the available evidence supporting the association between metabolic syndrome components and metabolic syndrome as a clinical entity with atrial fibrillation. IntroductionMetabolic syndrome (MS) represents a cluster of cardiovascular (CV) and metabolic derangements (ie, increased blood pressure, abdominal obesity, insulin resistance, and dyslipidemia), which deteriorate vascular function and cause subclinical damage in a variety of organs, more than traditional risk factors individually.1 Atrial fibrillation (AF) is certainly the most prevalent arrhythmia in everyday clinical practice, and its prevalence increases parallel to MS frequency. 2 Each of the MS components are related to increased risk for AF occurrence. However, the exact mechanisms of these relationships have not been studied enough. Because both of these conditions are associated with significant CV and cerebrovascular morbidity and mortality, it is important to assess the relationship between these 2 frequent conditions and to determine the mechanisms that connect them.For the purpose of this review article, we used PubMed, Medline, OVID, and EMBASE databases and searched for the studies published

Metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic

“…20,27 The presence of metabolic syndrome increases a patient's risk of developing AF and, for patients in AF, increases stroke risk ( Figure 1). …”

“…41,42 Mechanistically, insulin 8 resistance results in a pro-inflammatory environment within the myocardium, principally driven by elevations in levels of interleukin-1, C-reactive protein and reactive oxygen species. 27,43 This leads to myocardial remodelling, diastolic dysfunction and left atrial hypertrophy, changes collectively termed diabetic cardiomyopathy. 43,44 Together with associated autonomic neuropathy, these favour the development of AF.…”

Clinical update on metabolic syndrome

“…Generally, it has been related MS with higher risk of cardiovascular disease. More significantly, MS could increase the chance to suffer atrial fibrillation, an usual arrhythmia 42 . Factors involved would be oxidative stress, high blood pressure, low grade of inflammation, left atrial and ventricular remodeling and activation of renin-angitensinaldosterone system.…”

Evaluation of Electrocardiographic T-Peak to T-End Interval in Patients with Cardiac Syndrome X

“…Tp-e/ QT and Tp-e/QTc ratios have been suggested as more accurate measures for the dispersion of ventricular repolarization compared to others parameters, and are independent from heart rate alterations [5][6]. Previous studies have consistently shown an association between metabolic syndrome X (MSX) and atrial arrhythmia such as atrial fibrillation (AF) [7][8][9]. However, there is not much data regarding the association between CSX and ventricular arrhythmia.…”