Evidence map›Paper›PMID 31558158›Full record

ArticleCardiovascular diabetology2019

Atrial fibrillation and its arrhythmogenesis associated with insulin resistance.

Yi-Hsin Chan, Gwo-Jyh Chang, Ying-Ju Lai, Wei-Jan Chen, Shang-Hung Chang, Li-Man Hung, Chi-Tai Kuo, Yung-Hsin Yeh

Registry-linked trialOpen access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07551947 (HOMA-PULSE), which is not on this map. Cited by 101 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 6 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07551947 enrolling by invitationnot on this mapstarted 2026, after this paper: background citation

HOMA-PULSE: Assessment of Glucose Metabolism and Insulin Resistance as a Predictor of Pulsed Field Ablation Success in Atrial Fibrillation

TypeobservationalSponsorNemocnice AGEL Trinec-Podlesi a.s.Ran2026 to 2028Enrolled120ConditionsAtrial Fibrillation, Insulin Resistance, Catheter Ablation, Artificial Intelligence
3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 6 syntheses or guidelines pooled it, 184 citations in OpenAlex.

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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Yi-Hsin ChanCardiovascular Department, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Gwo-Jyh ChangGraduate Institute of Clinical Medical Sciences, Chang-Gung University, Taoyuan, Taiwan.
Ying-Ju LaiDepartment of Respiratory Therapy, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Wei-Jan ChenCardiovascular Department, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Shang-Hung ChangCardiovascular Department, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Li-Man HungDepartment of Biomedical Sciences, College of Medicine, Healthy and Aging Research Center, Chang-Gung University, Taoyuan, Taiwan.
Chi-Tai KuoCardiovascular Department, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. chitai@cgmh.org.tw.
Yung-Hsin YehCardiovascular Department, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. yys0tw@yahoo.ca.ORCID 0000-0003-1645-1941
Chang Gung University · TWChang Gung University of Science and Technology · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsulin resistance (IR) is considered as a risk factor for atrial fibrillation (AF) even before diabetes develops. The pathophysiology and underlying mechanism are largely unclear.

methodsWe investigated the corresponding mechanism in two IR models of rats fed 15-week high-fat (HFa) and high-fructose/cholesterol (HFr) diets. AF was evaluated and induced by burst atrial pacing. Isolated atrial myocytes were used for whole-cell patch clamp and calcium assessment. Ex vivo whole heart was used for optical mapping. Western blot and immunofluorescence were used for quantitative protein evaluation.

resultsBoth HFa and HFr rat atria were vulnerable to AF evaluated by burst atrial pacing. Isolated atrial myocytes from HFa and HFr rats revealed significantly increased sarcoplasmic reticulum calcium content and diastolic calcium sparks. Whole-heart mapping showed prolonged calcium transient duration, conduction velocity reduction, and repetitive ectopic focal discharge in HFa and HFr atria. Protein analysis revealed increased TGF-β1 and collagen expression; increased superoxide production; abnormal upregulation of calcium-homeostasis-related proteins, including oxidized CaMKIIδ, phosphorylated-phospholamban, phosphorylated-RyR-2, and sodium-calcium exchanger; and increased Rac1 activity in both HFa and HFr atria. We observed that inhibition of CaMKII suppressed AF in both HF and HFr diet-fed rats. In vitro palmitate-induced IR neonatal cardiomyocytes and atrial fibroblasts expressed significantly more TGF-β1 than did controls, suggesting paracrine and autocrine effects on both myocytes and fibroblasts.

conclusionsIR engenders both atrial structural remodeling and abnormal intracellular calcium homeostasis, contributing to increased AF susceptibility. The inhibition of CaMKII may be a potential therapeutic target for AF in insulin resistance.

Indexed as

Atrial RemodelingHeart RateInsulin ResistanceAction PotentialsAnimalsAtrial FibrillationBiomarkersBlood GlucoseCalcium-Calmodulin-Dependent Protein Kinase Type 2Calcium SignalingCells, CulturedCholesterol, DietaryDietary SugarsDiet, High-FatDisease Models, AnimalFibroblastsBiomarkersBlood GlucoseCalcium-Calmodulin-Dependent Protein Kinase Type 2Cholesterol, DietaryDietary SugarsFructoseInsulinTgfb1 protein, ratTransforming Growth Factor beta1Atrial fibrillationCaMKIIInsulin resistanceTGF-β

Identifiers

PMID31558158
PMCPMC6761716
OpenAlexW2976126564

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.