The Warburg effect: A new insight into atrial fibrillation

• Published in: Clinica chimica acta 2019-12, Vol.499, p.4-12
• Main Authors: Liu, Yaozhong, Bai, Fan, Liu, Na, Ouyang, Feifan, Liu, Qiming
• Format: Article
• Language: English
• Subjects: AMPK; Animals; Atrial fibrillation; Atrial Fibrillation - drug therapy; Atrial Fibrillation - metabolism; HIF-1α; Humans; Metabolism; Neoplasms - drug therapy; Neoplasms - metabolism; Signal Transduction; Warburg effect
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2019.08.029

Atrial fibrillation (AF) is the most common sustained arrhythmia. Atrial remodeling, including electrical/structural/autonomic remodeling, plays a vital role in AF pathogenesis. All of these have been shown to contribute continuously to the self-perpetuating nature of AF. The Warburg effect was found to play important roles in tumor and non-tumor disease. Recently, lots of studies documented altered atrial metabolism in AF, but the specific mechanism and the impact of these changes upon AF initiation/progression remain unclear. In this article, we review the metabolic consideration in AF comprehensively and observe the footprints of the Warburg effect. We also summarize the signaling pathway involved in the Warburg effect during AF—HIF-1α and AMPK, and discuss their potential roles in AF maintenance and progression. In conclusion, we give the innovative idea that the Warburg effect exists in AF and promotes the progression of AF. Targeting it may provide new therapies for AF treatment. •The Warburg effect exists in the fibrillating atria.•HIF-1α, the key regulator of the Warburg effect, plays important roles in AF.•AMPK, the negative regulator of the Warburg effect, exerts multifaceted roles in AF.•The Warburg effect may promote the maintenance and progress of AF vice versa.