scholarly journals Altered atrial restitution dynamics and refractoriness in metabolic syndrome due to up-regulation of potassium repolarizing currents increases susceptibility to atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C J Calvo ◽  
A Rodriguez ◽  
E Almar ◽  
O Arias ◽  
W Lozano ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Computational Models ◽  
Coconut Oil ◽  
Diabetic Patients ◽  
Model Parameters ◽  
Atrial Electrophysiology ◽  
Increased Risk ◽  
In Silico Models ◽  
High Sucrose

Abstract Background Metabolic alterations, such as Metabolic Syndrome (MS), describe an association of factors including diabetes, hypertension, obesity and dyslipidemia, linked to higher risk and prevalence of overall cardiovascular disease, arrhythmogenesis and sudden cardiac death. Obese and diabetic patients have shown an increased risk for developing atrial fibrillation (AF). However, underlying mechanisms are not understood. Purpose To study the effects of MS and obesity remodeling in atrial restitution dynamics, frequency-dependent adaptation, refractoriness and its potential susceptibility to AF. Methods Electrophysiological experimental data from High-fat (HF-O, standard rabbit chow with an additional 15% fat) and Hig-fat High-Sucrose Metabolic Syndrome (HFHS-MS, 10% hydrogenated coconut oil and 5% lard, 15% high-sucrose dissolved in water) rabbit models were used to adjust computational models atrial electrophysiology remodeling under each condition. Additionally, isoproterenol and AF conditions were considered to challenge both in-silico models. Validation and sensitivity analysis were performed for each model parameters. Computational simulations in conditions of pacing at different pacing cycle lengths was assessed at 100, 125, 150, 200, 250, 350, 450, 500, 650, 750, 850, 1000 ms. Restitution dynamics were automatically determined and analyzed, as well as restitution slopes and presence of automaticity, early after-depolarizations, alternans and cardiac arrhythmia induction. Results Shortening of action potential duration and refractoriness in the left atrium was observed under HFHS-MS. Upstroke velocity, maximum excitability and sodium availability were altered both in HF-O and HFHS-MS. HF-O remodeling showed presence of alternans at high pacing frequencies. Repolarization restitution was shortened in conditions of ISO and MS-AF. Restitution slopes were >1 in HF-O and HFHS-MS, which was correlated to higher susceptibility to AF, and further increased in MS-AF. Under MS-AF, abbreviation in APD in both atria, resulted in increased reentrant frequencies in AF, which was exacerbated under IK1 up-regulation, increasing atrial vulnerability. Conclusions HFHS-MS underlies modifications in atrial electrophysiology including shorter refractoriness in HFHS-MS, as well as modifications in atrial excitability, which may be pro-arrhythmic mainly at high frequency rates. This could be explained in part by an up-regulation of outward potassium channels. These results could partially explain increased susceptibility for AF in MS. FUNDunding Acknowledgement Type of funding sources: None.

Glucagon-like peptide-1 (GLP-1) Biological Role in Patients of Type 2 Diabetes and Metabolic Syndrome

2019 ◽  
Vol 56 (2) ◽  
pp. 227
Author(s):  
Mohammedziyad Abu Awad
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Glucagon Secretion ◽  
Diabetic Patients ◽  
Metabolic Disturbances ◽  
Cvd Risk ◽  
First Line Therapy ◽  
Increased Risk ◽  
Glucagon Like Peptide 1

<p style="margin: 0in 0in 10pt; text-align: justify; line-height: 200%;">Type2 diabetes is estimated to affect 380 million people worldwide in 2025. Patients of this disease are at increased risk of cardiovascular diseases (CVD).The CVD risk is greater when diabetic patients have metabolic syndrome. Thus, the management of metabolic syndrome and CVD is crucial for diabetic patient’s life progress. GLP-1 has positive biological influences on glucose metabolism control by inhibiting glucagon secretion, enhancing insulin secretion and protecting the effects of cells. GLP-1 was also found to have other positive influences including weight loss, appetite sensation and food intake. These are important factors in metabolic disturbances control and CVD management. The paper reviewed several studies regarding the GLP-1 positive concerns. In conclusion, the paper supports the modern proposal of GLP-1 RAs as a first line therapy in initially diagnosed type 2 diabetes patients.</p>

scholarly journals Analysis of serum leptin levels as a biomarker in metabolic syndrome in type 2 diabetic patients in Okhla industrial area

2019 ◽  
Vol 7 (11) ◽  
pp. 4340
Author(s):  
Juhi Aggarwal ◽  
Niharika Singh ◽  
Mayur Kumar
Keyword(s):  
Metabolic Syndrome ◽  
Lipid Profile ◽  
Blood Sugar ◽  
Fasting Blood Sugar ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Increased Risk ◽  
Study Results ◽  
Type 2 Diabetic

Background: Metabolic syndrome is a progressive disorder which includes a wide array of disorders i.e. central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. In patients with metabolic syndrome there is an increased risk of mortality due to coronary heart disease, stroke, vascular dysfunction etc. Obesity is one of the most crucial epidemics of modern times and hormone leptin plays an important role in regulation of body weight and energy balance.Methods: A total of 355 individuals were selected from the OPD, Department of general medicine at ESIC hospital, Okhla and it comprised of 196 males and 159 females suffering from type 2 diabetes mellitus with metabolic syndrome. The data was collected over a year i.e. June 2018 to July 2019. After baseline clinical and anthropometric evaluation, Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), lipid profile, Insulin (fasting), and leptin levels of the patients were analyzed.Results: Blood sugar fasting, blood sugar post prandial, lipid profile, leptin and insulin levels were increased significantly in female patients as compared to male patients with type 2 diabetic patients and metabolic syndrome.Conclusions: Based on the study results, it was found that leptin correlate significantly with metabolic syndrome and could be used as a biomarker for the early detection of the disease.

scholarly journals Metabolic syndrome identifies normal weight insulin-resistant stroke patients at risk for recurrent vascular disease

2018 ◽  
Vol 14 (6) ◽  
pp. 639-645 ◽  
Author(s):  
Jennifer L Dearborn ◽  
Catherine M Viscoli ◽  
Silvio E Inzucchi ◽  
Lawrence H Young ◽  
Walter N Kernan
Keyword(s):  
Myocardial Infarction ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Diabetic Patients ◽  
Insulin Resistant ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Patients At Risk

Background The obesity paradox refers to the finding in observational studies that patients with obesity have a better prognosis after stroke than normal weight patients. Aim To test the hypothesis that there might be important heterogeneity within the obese stroke population, such that those with metabolic syndrome would be at higher risk for stroke or myocardial infarction and all-cause mortality compared to patients without metabolic syndrome. Methods The Insulin Resistance Intervention after Stroke trial enrolled non-diabetic patients with a recent ischemic stroke or transient ischemic attack and insulin resistance. We examined the association between metabolic syndrome and outcome risk in patients with normal weight at entry (body mass index (BMI) = 18.5–24.9 kg/m2), overweight (BMI = 25–29.9 kg/m2), or obesity (BMI ≥ 30 kg/m2). Analyses were adjusted for demographic features, treatment assignment, smoking, and major comorbid conditions. Results Metabolic syndrome was not associated with greater risk for stroke or myocardial infarction among 1536 patients who were overweight (adjusted hazard ratio (HR), 0.95; 95% confidence interval (CI): 0.69–1.31) or 1626 obese patients (adjusted HR, 1.00; 95% CI: 0.70–1.41). However, among 567 patients with a normal BMI, metabolic syndrome was associated with increased risk for stroke or myocardial infarction (adjusted HR, 2.05; 95% CI: 1.25–3.37), and all-cause mortality (adjusted HR, 1.70; 95% CI: 1.03–2.81) compared to patients without metabolic syndrome. Conclusions The presence of metabolic syndrome identified normal weight patients with insulin resistance but no diabetes who have a higher risk of adverse cardiovascular outcomes, compared with patients without metabolic syndrome.

scholarly journals The Prevalence of Metabolic Syndrome and Its Components among Type 2 Diabetes Mellitus Patients at a Tertiary Hospital, Northwest Ethiopia

1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Belete Biadgo ◽  
Tadele Melak ◽  
Sintayehu Ambachew ◽  
Habtamu Wondifraw Baynes ◽  
Miteku Andualem Limenih ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Regression Analysis ◽  
Lifestyle Modification ◽  
Tertiary Hospital ◽  
Northwest Ethiopia ◽  
P Value ◽  
Diabetic Patients ◽  
Diabetes Clinic ◽  
Cross Sectional ◽  
Increased Risk

BACKGROUND: Metabolic syndrome is a cluster of risk factors that is responsible for the risk of coronary heart disease and stroke. Therefore, the aim of this study was to assess the prevalence of MetS and its components among T2DM patients.METHODS: A cross-sectional study was conducted at the Diabetes Clinic of the Hospital, from June to July, 2015. Data were entered into EPI INFO software and exported to SPSS 20 for analysis. MetS prevalence was estimated using NCEP ATPIII and IDF criteria. Anthropometric measurements, investigations of serum glucose and lipid profiles were done. Logistic regression analysis was used to evaluate associated factors. A P-value ≤ 0.05 wasconsidered statistically significant.RESULT: A total of 159 participants were included in the study; 119 (59.7%) were females with mean (±SD) age of (49.8±8.7) year. The prevalence of MetS was 66.7% in NCEP-ATP III and 53.5% in IDF definitions. The most prevalent component of MetS was elevated triglyceride (56.6% in ATPIII and 62.3% in IDF criteria), followed by abdominal obesity (61%) IDF and elevated blood pressure (55.4%) NCEP-ATPIII criteria. The regression analysis showed that increased age, being female, high BMI, having diabetes for over 5 years and poor glycemic control were significantly associated with metabolic syndrome.CONCLUSION: The prevalence of MetS and its components among T2DM patients were high, suggesting that diabetic patients are at increased risk of CVD and other complications. Efforts should be geared towards addressing these abnormalities through lifestyle modification, health awareness and medications in order to reduce this complication. 

METABOLIC SYNDROME IS ASSOCIATED WITH INCREASED RISK OF ATRIAL FIBRILLATION IN HYPERTENSIVE PATIENTS: PP.1.40

2010 ◽  
Vol 28 ◽  
pp. e58
Author(s):  
M Kallistratos ◽  
V Lezos ◽  
X Manetos ◽  
T Zamfir ◽  
X Koukosi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Hypertensive Patients ◽  
Increased Risk

scholarly journals Meta-analysis of metabolic syndrome and its individual components with risk of atrial fibrillation in different populations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Zheng ◽  
Zengshuo Xie ◽  
Jiayong Li ◽  
Chen Chen ◽  
Wenting Cai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Elevated Blood Pressure ◽  
Cochrane Library ◽  
Elevated Blood ◽  
Increased Risk

Abstract Background Recent studies have reported the effects of metabolic syndrome (MetS) and its components on atrial fibrillation (AF), but the results remain controversial. Therefore, we performed a meta-analysis to evaluate the relationship between MetS and AF risk. Methods Studies were searched from the Cochrane library, PubMed, and Embase databases through May 2020. Adjusted hazard ratios (HRs) and its corresponding 95% confidence intervals (CIs) were extracted and then pooled by using a random effects model. Results A total of 6 observational cohort studies were finally included. In the pooled analysis, MetS was associated with an increased risk of AF (HR 1.57; 95% CI 1.40–1.77; P < 0.01). And the components of MetS including abdominal obesity (HR 1.37; 95% CI 1.36–1.38; P < 0.01), elevated blood pressure (HR 1.56; 95% CI 1.46–1.66; P < 0.01), elevated fasting glucose (HR 1.18; 95% CI 1.15–1.21; P < 0.01) and low high density cholesterol (HDL) (HR 1.18; 95% CI 1.06–1.32; P < 0.01) was also associated with an increased risk of AF, while high triglyceride (HR 0.99; 95% CI 0.87–1.11, P = 0.82) was not. Conclusions Our present meta-analysis suggested that MetS, as well as its components including abdominal obesity, elevated blood pressure, elevated fasting glucose and low HDL cholesterol were associated with an increase in the risk of AF.

scholarly journals Metformin Is Associated with a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared to Sulfonylureas: An Observational Study

2021 ◽  
Author(s):  
Anna Ostropolets ◽  
Pierre A. Elias ◽  
Michael V. Reyes ◽  
Elaine Y. Wan ◽  
Utpal B. Pajvani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Diabetic Patients ◽  
Atrial Arrhythmias ◽  
Metformin Monotherapy ◽  
Increased Risk ◽  
Chronic Disorders ◽  
Reduced Risk

Background - Type 2 diabetes (DM2) is one of the most common chronic disorders worldwide and is an important cause of cardiovascular disease. Studies investigating the risk of atrial and ventricular arrhythmias in diabetic patients taking different oral diabetes medications are sparse. Methods - We used IBM MarketScan® Medicare Supplemental Database to examine the risk of arrhythmias for patients on different oral diabetes medications by propensity score matching. Results - We found that patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, including atrial fibrillation, compared to monotherapy with DPP4 or TZD medications. Patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, ventricular arrhythmias, and bradycardia compared to monotherapy with sulfonylureas. Combination therapy with sulfonylureas and metformin had an increased risk of atrial arrhythmias compared to some other combinations. Conclusions - Different oral diabetes medications have significantly different long-term risk of arrhythmia. Specifically, metformin is associated with reduced risk of atrial fibrillation and ventricular arrhythmias compared to sulfonylureas.

scholarly journals Primary prevention of atrial fibrillation in patients with metabolic syndrome: correction of modifiable risk factors

2021 ◽  
Vol 6 (2) ◽  
pp. 103-115
Author(s):  
A. I. Olesin ◽  
I. V. Konstantinova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Primary Prevention ◽  
High Risk ◽  
Modifiable Risk Factors ◽  
Financial Costs ◽  
Increased Risk

Currently, around 34 million people worldwide suffer from atrial fibrillation (AF), with the number projected to double by 2060. Despite the treatment of AF has been significantly improved during the recent years, AF is still associated with an increased risk of severe complications such as systemic thromboembolism, progression of heart failure, stroke, and myocardial infarction. Due to a high risk of disability and mortality, AF represent a major socioeconomic problem for the healthcare in most countries, also because of related financial costs. Obesity, most often represented by metabolic syndrome, is widely recognized as an epidemic of the XXI century. Here we review the features of AF development in patients with metabolic syndrome, suggesting novel avenues for the primary prevention of AF. 

scholarly journals Association of Antihyperglycemic Therapy with Risk of Atrial Fibrillation and Stroke in Diabetic Patients

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 592 ◽  
Author(s):  
Cristina-Mihaela Lăcătușu ◽  
Elena-Daniela Grigorescu ◽  
Cristian Stătescu ◽  
Radu Andy Sascău ◽  
Alina Onofriescu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Glycemic Control ◽  
Medical Literature ◽  
Diabetic Patients ◽  
Antidiabetic Agents ◽  
Cerebrovascular Events ◽  
Antihyperglycemic Therapy ◽  
Increased Risk ◽  
Patients With Diabetes

Type 2 diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease (CVD). Atrial fibrillation (AF) and stroke are both forms of CVD that have major consequences in terms of disabilities and death among patients with diabetes; however, they are less present in the preoccupations of scientific researchers as a primary endpoint of clinical trials. Several publications have found DM to be associated with a higher risk for both AF and stroke; some of the main drugs used for glycemic control have been found to carry either increased, or decreased risks for AF or for stroke in DM patients. Given the risk for thromboembolic cerebrovascular events seen in AF patients, the question arises as to whether stroke and AF occurring with modified incidences in diabetic individuals under therapy with various classes of antihyperglycemic medications are interrelated and should be considered as a whole. At present, the medical literature lacks studies specifically designed to investigate a cause–effect relationship between the incidences of AF and stroke driven by different antidiabetic agents. In default of such proof, we reviewed the existing evidence correlating the major classes of glucose-controlling drugs with their associated risks for AF and stroke; however, supplementary proof is needed to explore a hypothetically causal relationship between these two, both of which display peculiar features in the setting of specific drug therapies for glycemic control.

scholarly journals The Impact of Metabolic Syndrome on the Incidence of Atrial Fibrillation: A Nationwide Longitudinal Cohort Study in South Korea

2019 ◽  
Vol 8 (8) ◽  
pp. 1095 ◽  
Author(s):  
Kwon ◽  
Kim ◽  
Kim ◽  
Kim ◽  
Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
National Health ◽  
Fasting Glucose ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Increased Risk ◽  
The Impact

Aims: To evaluate the impact of metabolic syndrome (MetS) status on the incidence of atrial fibrillation (AF) in Koreans. Methods and results: Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. In total, 7,830,602 men and women (between 30 and 69 years of age) without baseline AF who underwent a national health examination between January 2009 and December 2009 were enrolled. Patients were evaluated to determine the impact of MetS status on their risk of developing AF until December 2016. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1–2 (Pre-MetS) or 3–5 (MetS). During a mean follow-up of 7.3 years, 20,708 subjects (0.26%) were diagnosed with AF. After multivariable adjustment, the risk of AF was significantly and positively correlated with MetS status (hazard ratios (HR) 1.391, 95% confidence interval (CI) 1.322–1.464 in Pre-MetS and HR 1.722, 95% CI 1.621–1.829 in MetS). When subgroup analyses were conducted according to MetS components, abdominal obesity (HR 1.316, p < 0.001), elevated blood pressure (HR 1.451, p < 0.001), and elevated fasting glucose (HR 1.163, p < 0.001) were associated with an increased risk of AF. Conclusion: MetS and pre-MetS are significantly associated with an increased risk of AF in Korean adults. Of the MetS components, abdominal obesity, elevated blood pressure, and elevated fasting glucose are potent risk factors for the risk of AF in this population.

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