nach oben

Erschienen in:

18.07.2022 | Schwerpunkt

Rhythmologische und metabolische Kontrolle

verfasst von: Dr. med. Denise Guckel, Prof. Dr. med. Christian Sohns, Prof. Dr. med. Philipp Sommer

Erschienen in: Herz | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Zusammenfassung

Diabetes mellitus und Vorhofflimmern (VHF) zeigen eine stetige Zunahme ihrer Prävalenz. Diabetes stellt einen relevanten, nicht zu unterschätzenden Risikofaktor für die Entstehung und Aufrechterhaltung von VHF dar. Im Rahmen eines Diabetes auftretende Schwankungen des Blutzuckerspiegels, inflammatorische Prozesse und oxidativer Stress führen zu strukturellen, elektromechanischen, elektrischen und autonomen Umbau-, d. h. Remodelling-Prozessen am Herzmuskel, welche VHF begünstigen. Wenn VHF und Diabetes aufeinandertreffen, ist dies häufig mit einer stärker ausgeprägten Symptomatik, einer geringeren Lebensqualität, häufigeren Hospitalisierungen und einer höheren Mortalität vergesellschaftet. Kann die frühe und konsequente euglykämische Blutzuckereinstellung atriale Remodelling-Prozesse, kardiovaskuläre Endpunkte und das Auftreten von VHF effektiv beeinflussen? Gibt es neue gemeinsame, medikamentöse Therapieansätze für die Behandlung von Diabetes und VHF? Welche Ablationsstrategie sollte bei der interventionellen Therapie von Vorhofflimmern bei Diabetespatienten gewählt werden? In diesem Übersichtsartikel wird versucht, Antworten auf diese Fragen zu finden.

Hindricks G, Potpara T, Dagres N, ESC Scientific Document Group et al (2021) 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for cardio-thoracic surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European society of cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the ESC. Eur Heart J 42:373–498PubMedCrossRef

Mahmood SS, Levy D, Vasan RS, Wang TJ (2014) The Framingham heart study and the epidemiology of cardiovascular disease: a historical perspective. Lancet 383:999–1008. https://doi.org/10.1016/S0140-6736(13)61752-3CrossRefPubMed

United Kingdom Prospective Diabetes Study (UKPDS) (1995) Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ 310(6972):83–88CrossRef

Huxley RR, Filion KB, Konety S, Alonso A (2011) Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. Am J Cardiol 08:56–62CrossRef

Benjamin EJ, Muntner P, Alonso A et al (2019) American heart association council on epidemiology and prevention statistics committee and stroke statistics subcommittee. Heart disease and stroke statistics-2019 update: a report from the American heart association. Circulation 139:e56–e528PubMedCrossRef

Costard-Jäckle A, Tschöpe D, Meinertz T (2019) Cardiovascular outcome in type 2 diabetes and atrial fibrillation. Herz 44:522–525PubMedCrossRef

Stegmann C, Jahnke C, Paetsch I et al (2018) Association of left ventricular late gadolinium enhancement with left atrial low voltage areas in patients with atrial fibrillation. Europace 20:1606–1611PubMedCrossRef

Du X, Ninomiya T, de Galan B, ADVANCE Collaborative Group et al (2009) Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study. Eur Heart J 30:1128–1135PubMedCrossRef

Kumar N, Echouffo-Tcheugui JB (2021) Diabetes and atrial fibrillation in hospitalized patients in the United States. Clin Cardiol 44:340–348PubMedPubMedCentralCrossRef

10.

Wang A, Green JB, Halperin JL et al (2019) Atrial fibrillation and diabetes mellitus: JACC review topic of the week. J Am Coll Cardiol 74:1107–1115PubMedCrossRef

11.

Ostgren CJ, Merlo J, Råstam L, Lindblad U (2004) Atrial fibrillation and its association with type 2 diabetes and hypertension in a Swedish community. Diabetes Obes Metab 6:367–374PubMedCrossRef

12.

Chan YH, Chang GJ, Lai YJ et al (2019) Atrial fibrillation and its arrhythmogenesis associated with insulin resistance. Cardiovasc Diabetol 18:125PubMedPubMedCentralCrossRef

13.

Chang SL, Tuan TC, Tai CT et al (2009) Comparison of outcome in catheter ablation of atrial fibrillation in patients with versus without the metabolic syndrome. Am J Cardiol 103:67–72PubMedCrossRef

14.

Chao TF, Suenari K, Chang SL et al (2010) Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose. Am J Cardiol 106:1615–1620PubMedCrossRef

15.

Guckel D, Isgandarova K, Bergau L et al (2021) The effect of diabetes mellitus on the recurrence of atrial fibrillation after ablation. J Clin Med 10:4863PubMedPubMedCentralCrossRef

16.

Echouffo-Tcheugui JB, Shrader P, Thomas L et al (2017) Care patterns and outcomes in atrial fibrillation patients with and without diabetes: ORBIT-AF registry. J Am Coll Cardiol 70:1325–1335PubMedCrossRef

17.

Targher G, Mantovani A, Pichiri I et al (2013) Non-alcoholic fatty liver disease is associated with an increased prevalence of atrial fibrillation in hospitalized patients with type 2 diabetes. Clin Sci (Lond) 125:301–309CrossRef

18.

Goudis CA, Kallergis EM, Vardas PE (2012) Extracellular matrix alterations in the atria: insights into the mechanisms and perpetuation of atrial fibrillation. Europace 14:623–630. https://doi.org/10.1093/europace/eur398CrossRefPubMed

19.

Gu J, Fan YQ, Zhang JF, Wang CQ (2017) Impact of long-term glycemic variability on development of atrial fibrillation in type 2 diabetic patients. Anatol J Cardiol 18:410–416PubMedPubMedCentral

20.

Qi W, Zhang N, Korantzopoulos P et al (2017) Serum glycated hemoglobin level as a predictor of atrial fibrillation: a systematic review with meta-analysis and meta-regression. PLoS ONE 12:e170955PubMedPubMedCentralCrossRef

21.

Iguchi Y, Kimura K, Shibazaki K et al (2012) HbA1c and atrial fibrillation: a cross-sectional study in Japan. Int J Cardiol 156:156–159PubMedCrossRef

22.

Li Y, Liu B, Li Y et al (2019) Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis. Cardiovasc Diabetol 18:3PubMedPubMedCentralCrossRef

23.

Otake H, Suzuki H, Honda T, Maruyama Y (2009) Influences of autonomic nervous system on atrial arrhythmogenic substrates and the incidence of atrial fibrillation in diabetic heart. Int Heart J 50:627–641PubMedCrossRef

24.

Guckel D, Schmidt A, Gutleben KJ et al (2020) Pulmonary vein isolation and beyond: predictive value of vagal reactions in second-generation cryoballoon ablation for the outcome of persistent atrial fibrillation. Heart Rhythm 17:600–606PubMedCrossRef

25.

Jenkins DJA, Dehghan M, Mente A, PURE Study Investigators et al (2021) Glycemic index, glycemic load, and cardiovascular disease and mortality. N Engl J Med 384:1312–1322PubMedCrossRef

26.

McGuire DK, Shih WJ, Cosentino F et al (2021) Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: a meta-analysis. JAMA Cardiol 6:148–158PubMedCrossRef

27.

Palmer SC, Tendal B, Mustafa RA et al (2021) Sodium-glucose cotransporter protein‑2 (SGLT-2) inhibitors and glucagon-like peptide‑1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials. BMJ 372:m4573PubMedPubMedCentralCrossRef

28.

McDonagh TA, Metra M, Adamo M, ESC Scientific Document Group et al (2021) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42:3599–3726PubMedCrossRef

29.

Zelniker TA, Bonaca MP, Furtado RHM et al (2020) Effect of dapagliflozin on atrial fibrillation in patients with type 2 diabetes mellitus: insights from the DECLARE-TIMI 58 trial. Circulation 141:1227–1234PubMedCrossRef

30.

Sato T, Aizawa Y, Yuasa S et al (2018) The effect of dapagliflozin treatment on epicardial adipose tissue volume. Cardiovasc Diabetol 17:6PubMedPubMedCentralCrossRef

31.

Filippatos G, Anker SD, Agarwal R, FIDELIO-DKD Investigators et al (2021) Finerenone and cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes. Circulation 143:540–552PubMedCrossRef

32.

Filippatos G, Anker SD, Agarwal R, FIGARO-DKD Investigators et al (2022) Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation 145:437–447PubMedCrossRef

33.

Agarwal R, Filippatos G, Pitt B, FIDELIO-DKD, FIGARO-DKD investigators et al (2022) Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J 43:474–484PubMedCrossRef

34.

Swedberg K, Zannad F, McMurray JJ, EMPHASIS-HF Study Investigators et al (2012) Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (eplerenone in mild patients hospitalization and survival study in heart failure) study. J Am Coll Cardiol 59:1598–1603PubMedCrossRef

35.

Neefs J, van den Berg NWE, Krul SPJ et al (2020) Effect of spironolactone on atrial fibrillation in patients with heart failure with preserved ejection fraction: post-hoc analysis of the randomized, placebo-controlled TOPCAT trial. Am J Cardiovasc Drugs 20:73–80PubMedCrossRef

36.

Lavall D, Selzer C, Schuster P et al (2014) The mineralocorticoid receptor promotes fibrotic remodeling in atrial fibrillation. J Biol Chem 289:6656–6668PubMedPubMedCentralCrossRef

37.

Williams SE, Linton NWF, Harrison J et al (2017) Intra-atrial conduction delay revealed by multisite incremental atrial pacing is an independent marker of remodeling in human atrial fibrillation. JACC Clin Electrophysiol 3:1006–1017PubMedPubMedCentralCrossRef

38.

Williams SE, Linton N, O’Neill L et al (2017) The effect of activation rate on left atrial bipolar voltage in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 28:1028–1036. https://doi.org/10.1111/jce.13282CrossRefPubMedPubMedCentral

39.

Arentz T, Weber R, Bürkle G et al (2007) Small or large isolation areas around the pulmonary veins for the treatment of atrial fibrillation? Results from a prospective randomized study. Circulation 115:3057–3063. https://doi.org/10.1161/CIRCULATIONAHA.107.690578CrossRefPubMed

40.

Ouyang F, Ernst S, Chun J et al (2005) Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique. Circulation 112:3038–3048PubMedCrossRef

41.

Rottner L, Metzner A, Ouyang F et al (2017) Direct comparison of point-by-point and rapid ultra-high-resolution electroanatomical mapping in patients scheduled for ablation of atrial fibrillation. J Cardiovasc Electrophysiol 28:289–297PubMedCrossRef

42.

Borlich M, Iden L, Kuhnhardt K et al (2018) 3D mapping for PVI- geometry, image integration and incorporation of contact force into work flow. J Atr Fibrillation 10:1795PubMedPubMedCentralCrossRef

43.

Rolf S, Schoene K, Kircher S et al (2019) Catheter ablation of atrial fibrillation with nonfluoroscopic catheter visualization‑a prospective randomized comparison. J Interv Card Electrophysiol 54:35–42PubMedCrossRef

44.

Paetsch I, Jahnke C, Hilbert S et al (2017) Cardiovascular magnetic resonance-guided electrophysiological interventions: radiofrequency ablation of typical atrial flutter. Circ Cardiovasc Imaging 10:e5780PubMedCrossRef

45.

Kowallick JT, Staab W, Schuster A et al (2019) Reverse left ventricular structural remodeling after catheter ablation of atrial fibrillation in patients with preserved left ventricular function: insights from cardiovascular magnetic resonance native T1 mapping. Heart Rhythm 16:424–432PubMedCrossRef

46.

Marrouche NF, Wilber D, Hindricks G et al (2014) Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA 311:498–506PubMedCrossRef

47.

ElMaghawry M, Romeih S (2015) DECAAF: emphasizing the importance of MRI in AF ablation. Glob Cardiol Sci Pract 2015:8PubMedPubMedCentralCrossRef

48.

Siebermair J, Kholmovski EG, Marrouche N (2017) Assessment of left atrial fibrosis by late gadolinium enhancement magnetic resonance imaging: methodology and clinical implications. JACC Clin Electrophysiol 3:791–802PubMedCrossRef

49.

Akoum N, Wilber D, Hindricks G et al (2015) MRI assessment of ablation-induced scarring in atrial fibrillation: analysis from the DECAAF study. J Cardiovasc Electrophysiol 26:473–480PubMedCrossRef

50.

Marrouche NF, Greene T, Dean JM et al (2021) Efficacy of LGE-MRI-guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: the DECAAF II trial: study design. J Cardiovasc Electrophysiol 32:916–924PubMedCrossRef

51.

Akoum N, Daccarett M, McGann C et al (2011) Atrial fibrosis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation: a DE-MRI guided approach. J Cardiovasc Electrophysiol 22:16–22PubMedCrossRef

52.

Lin CS, Pan CH (2008) Regulatory mechanisms of atrial fibrotic remodeling in atrial fibrillation. Cell Mol Life Sci 65:1489–1508PubMedCrossRef

53.

Egert S, Baxheinrich A, Lee-Barkey YH et al (2014) Effects of an energy-restricted diet rich in plant-derived alpha-linolenic acid on systemic inflammation and endothelial function in overweight-to-obese patients with metabolic syndrome traits. Br J Nutr 112:1315–1322PubMedCrossRef

Titel: Rhythmologische und metabolische Kontrolle
verfasst von: Dr. med. Denise Guckel
Prof. Dr. med. Christian Sohns
Prof. Dr. med. Philipp Sommer
Publikationsdatum: 18.07.2022
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 5/2022
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-022-05128-4

Neu im Fachgebiet Kardiologie

23.04.2024 | Ablationstherapie | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Rhythmologische und metabolische Kontrolle

Zusammenfassung

Neu im Fachgebiet Kardiologie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Kardiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2022

Herz und Diabetes

Herz und Diabetes

Treatment of heart failure with preserved ejection fraction with SGLT2 inhibitors: new therapy standard?

Back to the roots of cardiometabolic care

First experiences with a new balloon-expandable Myval transcatheter aortic valve: a preliminary study

Erratum to: Outcomes of patients with ST-segment myocardial infarction admitted during the COVID-19 pandemic

Neu im Fachgebiet Kardiologie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Kardiologie