Body
mass index (BMI) is a powerful predictor of death, type 2 diabetes (T2DM) and
cardiovascular (CV) morbidity and mortality [1, 2]. Over the last few decades,
we have witnessed a global rise in adult obesity of epidemic proportions. Similarly
,there has been a parallel increase in the incidence of atrial fibrillation
(AF), itself a significant cause of cardiovascular morbidity and mortality.
This may be partly attributable to advances in the treatment of coronary heart
disease (CHD) and heart failure (HF) improving life expectancy however,
epidemiological studies have demonstrated an independent association between
obesity, diabetes and AF, suggesting possible
common pathophysiologal mechanisms and risk factors. Indeed, cardiac remodeling,
haemodynamic alterations, autonomic dysfunction, and diastolic dysfunction have
been reported in obese and diabetic cohorts. Moreover, diabetic cardiomyopathy
is characterized by an adverse structural and functional cardiac phenotype
which may predispose to the development of AF [3].
In this review, we discuss the pathophysiological and mechanistic relationships
between obesity, diabetes and AF, and some of the challenges posed in the
management of this high-risk group of individuals.
Credits: Asghar O; Alam U; Hayat SA; Aghamohammadzadeh R; Heagerty AM; Malik RA