Risk factors of atrial fibrillation and their modification: a new look at a long-term problem

T.M.  Babkina; H.S. Smyrnova; L.Yu. Hladka; O.V. Polishchuk

doi:10.26641/2307-0404.2021.3.241881

Автор(и)

T.M. Babkina Shupyk National Healthcare University of Ukraine Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Україна https://orcid.org/0000-0001-5046-870X
H.S. Smyrnova Shupyk National Healthcare University of Ukraine Dorohozhytska str., 9, Kyiv, 04112, Ukrain, Україна https://orcid.org/0000-0001-8788-7975
L.Yu. Hladka Shupyk National Healthcare University of Ukraine Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Україна https://orcid.org/0000-0003-3008-9870
O.V. Polishchuk Shupyk National Healthcare University of Ukraine Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Україна https://orcid.org/0000-0001-7796-4770

DOI:

https://doi.org/10.26641/2307-0404.2021.3.241881

Ключові слова:

atrial fibrillation, risk factors, risk factor modification, American Heart Association

Анотація

Atrial fibrillation (AF) is one of the most common arrhythmias diagnosed in clinical practice. Today, AF is associated with an increased risk of mortality, acute brain disorders, and heart failure. The results of many studies suggest that the incidence of AF is directly related to such risk factors (RF) as age, obesity, hypertension, diabetes mellitus, obstructive sleep apnea, alcohol, tobacco smoking etc. Recently published studies have described the positive impact of lifestyle changes on the incidence of AF. Therefore, it is believed that early detection of RF could prevent or delay the onset of AF. New data suggest the need to review the management of patients with AF. In 2020, the American Heart Association has presented a scientific statement that highlighted the relationship between modified RF and AF, discussed the implementation of strategies for effective modification of RF, as well as identified areas for new research. The data allow us to conclude that the correction of RF helps to reduce the incidence of AF. Future research is needed to establish the effects and generalizability of systematic lifestyle and RF modification for AF: to study the role of pericardial/epicardial fat accumulation in risk and progression of AF; determination of the most effective weight loss techniques for long-term success in reducing AF; effects of high-intensity/short-duration interval training on left atrium structural and electric remodeling; the degree of glycemic control for AF.

Посилання

Beljuk NS, Snezhickij VA. [Risk factors of atrial fibrillation]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta. 2020;18(1):73-78. Russian.

Romanova EN. [Atrial fibrillation and obesity: what eludes our attention?]. Zdorovia Ukrainy. 2019;20(465):27-29. Russian.

Wright JT Jr, Williamson JD, Whelton PK, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103-16. doi: https://doi.org/10.1056/NEJMoa1511939

Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace. 2009;11:1156-9. doi: https://doi.org/10.1093/europace/eup197

Malmo V, Nes BM, Amundsen BH, et al. Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial. Circulation. 2016;133:466-73. doi: https://doi.org/10.1161/CIRCULATIONAHA.115.018220

Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64:2222-31. doi: https://doi.org/10.1016/j.jacc.2014.09.028

Linz D, McEvoy RD, Cowie MR, et al. As¬sociations of obstructive sleep apnea with atrial fibrillation and continuous positive airway pressure treatment: a review. JAMA Cardiol. 2018;3:532-40. doi: https://doi.org/10.1001/jamacardio.2018.0095

Morillo CA, Banerjee А, Perel Р, et al. Atrial fibrillation: the current epidemic. J Geriatr Cardiol. 2017;14:195-203.

McEvoy RD, Antic NA, Heeley E, et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med. 2016;375:919-31. doi: https://doi.org/10.1056/NEJMoa1606599

Alonso A, Bahnson JL, Gaussoin SA, et al. Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial. Am Heart J. 2015;170:770-7. doi: https://doi.org/10.1016/j.ahj.2015.07.026

Lakkireddy D, Atkins D, Pillarisetti J, et al. Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study. J Am Coll Cardiol. 2013;61:1177-82. doi: https://doi.org/10.1016/j.jacc.2012.11.060

Fenger-Grøn M, Vinter N., Frost L. Body mass and atrial fibrillation risk: Status of the epidemiology concerning the influence of fat versus lean body mass. Trends in Cardiovascular Medicine. 2020;30:205-11. doi: https://doi.org/10.1016/j.tcm.2019.05.009

Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141:e139-e596. doi: https://doi.org/10.1161/CIR.0000000000000746

Pathak RK, Elliott A, Middeldorp ME, et al. Impact of CARDIOrespiratory FITness on Arrhythmia Re¬currence in Obese Individuals With Atrial Fibrillation: the CARDIO-FIT Study. J Am Coll Cardiol. 2015;66:985-96. doi: https://doi.org/10.1016/j.jacc.2015.06.488

Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function: the strong heart study. Circulation. 2000;101:2271-6. doi: https://doi.org/10.1161/01.CIR.101.19.2271

Holmqvist F, Guan N, Zhu Z, et al. Impact of ob¬structive sleep apnea and continuous positive airway pressure therapy on outcomes in patients with atrial fibrillation: results from the OutcomesRegistry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J. 2015;169:647-54. doi: https://doi.org/10.1016/j.ahj.2014.12.024

Fenger-Gron M, Overvad K, Tjonneland A, et al. Lean body mass is the predominant anthropometric risk factor for atrial fibrillation. J Am Coll Cardiol. 2017;69:2488-97. doi: https://doi.org/10.1016/j.jacc.2017.03.558

Chung MK, Eckhardt LL, Chen Lin Y, et al. Lifestyle and Risk Factor Modification for Reduction of Atrial Fibrillation. A Scientific Statement From the American Heart Association. Circulation. 2020;141:e750-72. doi: https://doi.org/10.1161/CIR.0000000000000748

Staerk L, Wang B, Preis SR, et al. Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study. BMJ. 2018;361:k1453.

Lin GM, Colangelo LA, Lloyd-Jones DM. Association of Sleep Apnea and Snoring with Incident Atrial Fibrillation in the Multi-Ethnic Study of Atherosclerosis. American Journal of Epidemiology. 2015;182(1):49-57. doi: https://doi.org/10.1093/aje/kwv004

Pathak RK, Middeldorp ME, Meredith M, et al. Long-Term Effect Of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: a long-term follow-up study (LEGACY). J Am Coll Cardiol. 2015;65:2159-69. doi: https://doi.org/10.1016/j.jacc.2015.03.002

Huxley RR, Filion KB, Konety S, et al. Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. Am J Cardiol. 2011;108:56-62. doi: https://doi.org/10.1016/j.amjcard.2011.03.004

Qureshi WT, Nasir UB, Alqalyoobi S, et al. Meta-analysis of continuous positive airway pressure as a therapy of atrial fibrillation in obstructive sleep apnea. Am J Cardiol. 2015;116:1767-1773. doi: https://doi.org/10.1016/j.amjcard.2015.08.046

Liu CY, Bluemke DA, Gerstenblith G, et al. Myocardial steatosis and its association with obesity and regional ventricular dysfunction: evaluated by magnetic resonance tagging and 1H spectroscopy in healthy African Americans. Int J Cardiol. 2014;172(2):381-7. doi: https://doi.org/10.1016/j.ijcard.2014.01.074

Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471-7. doi: https://doi.org/10.1001/jama.292.20.2471

Middeldorp ME, Pathak RK, Meredith M, et al. PREVEntion and regReSsive Effect of weight-loss and risk factor modification on Atrial Fibrillation: the REVERSE-AF study. Europace. 2018;20:1929-35. doi: https://doi.org/10.1093/europace/euy117

Andersen K, Farahmand B, Ahlbom A, et al. Risk of arrhythmias in 52 755 long-distance crosscountry skiers: a cohort study. Eur Heart J. 2013;34:3624-31. doi: https://doi.org/10.1093/eurheartj/eht188

Seyed Ahmadi S, Svensson AM, Pivodic A, et al. Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study. Cardiovasc Diabetol. 2020;19(1):9. doi: https://doi.org/10.1186/s12933-019-0983-1

Rienstra M, Hobbelt AH, Alings M, et al. Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J. 2018;39:2987-96. doi: https://doi.org/10.1093/eurheartj/ehx739

Abumuamar AM, Dorian P, Newman D, et al. The prevalence of obstructive sleep apnea in patients with atrial fibrillation. Clin Cardiol. 2018;41:601-7. doi: https://doi.org/10.1002/clc.22933

Craig T. January, L. Samuel Wann, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Circulation. 2019;140:125-51. doi: https://doi.org/10.1161/CIR.0000000000000665

Larsson SC, Wallin A, Hakansson N, et al. Type 1 and type 2 diabetes mellitus and incidence of seven cardiovascular diseases. Int J Cardiol. 2018;262:66-70. doi: https://doi.org/10.1016/j.ijcard.2018.03.099