Metabolic remodelling in atrial fibrillation: manifestations, mechanisms and clinical implications

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Item Type:	Review
Title:	Metabolic remodelling in atrial fibrillation: manifestations, mechanisms and clinical implications
Creators Name:	Bode, D., Pronto, J.R.D., Schiattarella, G.G. and Voigt, N.
Abstract:	Atrial fibrillation (AF) is a continually growing health-care burden that often presents together with metabolic disorders, including diabetes mellitus and obesity. Current treatments often fall short of preventing AF and its adverse outcomes. Accumulating evidence suggests that metabolic disturbances can promote the development of AF through structural and electrophysiological remodelling, but the underlying mechanisms that predispose an individual to AF are aetiology-dependent, thus emphasizing the need for tailored therapeutic strategies to treat AF that target an individual's metabolic profile. AF itself can induce changes in glucose, lipid and ketone metabolism, mitochondrial function and myofibrillar energetics (as part of a process referred to as 'metabolic remodelling'), which can all contribute to atrial dysfunction. In this Review, we discuss our current understanding of AF in the setting of metabolic disorders, as well as changes in atrial metabolism that are relevant to the development of AF. We also describe the potential of available and emerging treatment strategies to target metabolic remodelling in the setting of AF and highlight key questions and challenges that need to be addressed to improve outcomes in these patients.
Keywords:	Animals, Atrial Fibrillation, Atrial Remodeling, Energy Metabolism, Heart Atria
Source:	Nature Reviews Cardiology
ISSN:	1759-5002
Publisher:	Nature Publishing Group
Volume:	21
Number:	10
Page Range:	682-700
Date:	October 2024
Official Publication:	https://doi.org/10.1038/s41569-024-01038-6
PubMed:	View item in PubMed

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