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Lim MW, Kalman JM. The impact of lifestyle factors on atrial fibrillation. J Mol Cell Cardiol 2024; 193:91-99. [PMID: 38838814 DOI: 10.1016/j.yjmcc.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/04/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
Atrial fibrillation (AF), with its significant associated morbidity and mortality contributes to significant healthcare utilisation and expenditure. Given its progressively rising incidence, strategies to limit AF development and progression are urgently needed. Lifestyle modification is a potentially potent but underutilised weapon against the AF epidemic. The purpose of this article is to review the role of lifestyle factors as risk factors for AF, outline potential mechanisms of pathogenesis and examine the available evidence for lifestyle intervention in primary and secondary AF prevention. It will also highlight the need for investment by physicians, researchers, health services and governments in order to facilitate delivery of the comprehensive, multidisciplinary AF care that is required to manage this complex and multifactorial disease.
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Affiliation(s)
- Michael W Lim
- Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Jonathan M Kalman
- Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, Australia; The Baker Heart and Diabetes Research Institute, Melbourne, Australia.
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Chidipi B, Chang M, Abou-Assali O, Reiser M, Tian Z, Allen-Gipson D, Noujaim SF. The Arf6/PIP5K pathway activates IKACh in cigarette smoke mediated atrial fibrillation. Cell Signal 2022; 100:110475. [PMID: 36150420 DOI: 10.1016/j.cellsig.2022.110475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Cigarette smoking (CS) is a major cause of cardiovascular diseases. Smokers are at a significantly higher risk for developing atrial fibrillation (AF), a dangerous and abnormal heart rhythm. In the US, 15.5% of adults are current smokers, and it is becoming clear that CS is an independent risk factor for AF, but a detailed mechanistic understanding of how CS contributes to the molecular patho-electrophysiology of AF remains elusive. We investigated if CS related AF is in part mediated through a mechanism that depends on the cardiac acetylcholine activated inward rectifier potassium current (IKACh). We tested the hypothesis that CS increases IKACh via phosphatidylinositol 4-phosphate 5-kinase alpha (PIP5K) and ADP ribosylation factor 6 (Arf6) signaling, leading to AF perpetuation. In vivo inducibility of AF was assessed in mice exposed to CS for 8 weeks. AF duration was increased in CS exposed mice, and TertiapinQ, an IKACh blocker prevented AF development in CS exposed mice. In HEK293 cells stably transfected with Kir3.1 and Kir3.4, the molecular correlates of IKACh, CS exposure increased the expression of the Kir3.1 and Kir3.4 proteins at the cell surface, activated Arf6 and increased the IKACh current. Inhibition of PIP5K, or of Kir3.1/Kir3.4 trafficking via Arf6 abrogated the CS effects on IKACh. Cigarette smoke modifies the atrial electrophysiological substrate, leading to arrhythmogenesis, in part, through IKACh activation via an Arf6/PIP5K dependent pathway.
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Affiliation(s)
- Bojjibabu Chidipi
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America..
| | - Mengmeng Chang
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Obada Abou-Assali
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Michelle Reiser
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Zhi Tian
- Department of Pharmaceutical Science, USF Health Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States of America
| | - Diane Allen-Gipson
- Department of Pharmaceutical Science, USF Health Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States of America
| | - Sami F Noujaim
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
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Lu Y, Guo Y, Lin H, Wang Z, Zheng L. Genetically determined tobacco and alcohol use and risk of atrial fibrillation. BMC Med Genomics 2021; 14:73. [PMID: 33750369 PMCID: PMC7944892 DOI: 10.1186/s12920-021-00915-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 02/21/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The causality between the use of alcohol and cigarettes and atrial fibrillation (AF) remains controversial. We conducted a Mendelian randomization (MR) study to evaluate the association of genetic variants related to tobacco and alcohol use with AF. METHODS Single nucleotide polymorphisms (SNPs) related to smoking initiation (N = 374), age at initiation of regular smoking (N = 10), cigarettes per day (N = 55), and smoking cessation (N = 24) were derived from a genome-wide association studies (GWAS) of tobacco use (N = 1.2 million individuals). SNPs related to heavy alcohol use (N = 6) were derived from a GWAS of UK biobank (N = 125,249 individuals). The genetically matching instrumented variables were obtained from the GWAS of AF (N = 588,190 individuals). The estimates between tobacco and alcohol use and AF were combined by inverse-variance weighted (IVW), simple median, weighted median, MR-robust adjusted profile score method, MR-PRESSO, and multivariable MR. RESULTS A total of 65,446 AF patients and 522,744 referents were included. In the IVW analysis, the odds ratio per one-unit increase of smoking initiation was 1.11 (95% CI, 1.06-1.16; P = 3.35 × 10-6) for AF. Genetically predicted age at initiation of regular smoking, cigarettes per day and smoking cessation were not associated with AF. The IVW estimate showed that heavy alcohol consumption increased AF risk (OR, 1.11; 95% CI, 1.04-1.18; P = 0.001). The results were consistent in complementary analyses and multivariable MR. CONCLUSION Our MR study indicated that regular smoking was associated with increased risk of AF, no matter the age at initiation of regular smoking, or the number of cigarettes smoked per day. Genetically predicted heavy alcohol consumption increased the risk of AF.
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Affiliation(s)
- Yunlong Lu
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Yan Guo
- Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Hefeng Lin
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Zhen Wang
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Liangrong Zheng
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
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Bonaldi C, Pasquereau A, Hill C, Thomas D, Moutengou E, Thanh VN, Olié V. Hospitalizations for cardiovascular diseases attributable to tobacco smoking in France in 2015. Eur J Prev Cardiol 2019; 28:1327-1333. [PMID: 34647590 DOI: 10.1177/2047487319885462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Abstract
AIMS Tobacco smoking is a major risk factor for many cardiovascular diseases. In France, the daily smoking prevalence is among the highest in high-income European countries. This study estimated the number of hospitalizations for cardiovascular diseases attributable to smoking in France in 2015, and the number of stays that could have been avoided if there had been 10% less current smokers or if the prevalence of current smokers had been 20%. METHODS Age- and sex-specific attributable fractions were calculated by combining relative risks extracted from the literature with the prevalence of smoking estimated in the 2014 Health Barometer, a national representative survey. These fractions were applied to hospitalization stays with a primary diagnosis for a cardiovascular disease whose risk is known to increase with smoking. RESULTS In France in 2015, 250,813 hospital stays (95% uncertainty interval=234,869-269,807) related to a cardiovascular condition were estimated as attributable to smoking. This represented 21% of all stays for a cardiovascular condition. Ischemic heart disease accounted for the largest share of smoking-related stays (39%). If the number of current smokers had been 10% lower or if the prevalence of smoking in the population had dropped to below 20%, 5867 stays and 25,911 stays, respectively, would have been prevented. CONCLUSIONS In France, a large number of hospital stays for cardiovascular disease are attributable to tobacco smoking. A 10% reduction in smoking would avoid nearly 6000 hospital stays per year; more than 25,000 annual hospital stays if only 20% of the French population smoked.
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Affiliation(s)
| | - Anne Pasquereau
- Health Promotion and Prevention Division, Santé publique France, Saint Maurice, France
| | | | - Daniel Thomas
- Université Paris-VI-Sorbonne, AP-HP, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elodie Moutengou
- Data Science Division, Santé publique France, Saint Maurice, France
| | - Viêt Nguyen Thanh
- Health Promotion and Prevention Division, Santé publique France, Saint Maurice, France
| | - Valérie Olié
- Non-Communicable Diseases and Trauma Division, Santé Publique France, Saint Maurice, France
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Soltész B, Urbancsek R, Pös O, Hajas O, Forgács IN, Szilágyi E, Nagy-Baló E, Szemes T, Csanádi Z, Nagy B. Quantification of peripheral whole blood, cell-free plasma and exosome encapsulated mitochondrial DNA copy numbers in patients with atrial fibrillation. J Biotechnol 2019; 299:66-71. [PMID: 31063814 DOI: 10.1016/j.jbiotec.2019.04.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/18/2019] [Accepted: 04/20/2019] [Indexed: 12/22/2022]
Abstract
Mitochondrial DNA (mtDNA) copy number changes have been associated with various diseases. Several studies showed that mtDNA content in peripheral blood was associated with oxidative stress and cardiovascular disease. Atrial fibrillation (AF) is one of the severe cardiovascular diseases. We aimed to determine the mtDNA copy numbers in peripheral blood, in cell-free plasma and in exosomes of AF patients and healthy controls. Peripheral blood was drawn from 60 AF patients and 72 healthy controls. DNA was isolated from EDTA blood and plasma. Exosomes were isolated from cell-free plasma and then exosome encapsulated DNA (exoDNA) was extracted. Quantitative-real-time PCR was performed with Human Mitochondrial DNA (mtDNA) Monitoring Primer Set. Statistical analysis of the data was performed. We found statistically significant difference in mtDNA copy numbers in DNA isolated from peripheral whole blood, cell-free plasma and exosome samples of controls' (44.4 ± 18.0, 27.2 ± 30.1, 11.5 ± 8.7), and patients' group (43.4 ± 13.6, 26.2 ± 26.4, 14.5 ± 12.3). However there was no significant difference in mtDNA copy number between the two study groups either in peripheral blood, in cell-free plasma and in exosomes, and even in different sexes and ages. We found the highest copy number of mtDNA in peripheral blood, followed by plasma and exosomes. We did not find differences between patients and controls, neither age nor gender had effect on the mtDNA copy number. According to our results the mtDNA copy numbers did not differ in AF patients.
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Affiliation(s)
- Beáta Soltész
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Réka Urbancsek
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ondrej Pös
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Orsolya Hajas
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildikó Noémi Forgács
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Edina Szilágyi
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Edina Nagy-Baló
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tomas Szemes
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Zoltán Csanádi
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bálint Nagy
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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