{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:49:07Z","timestamp":1787795347719,"version":"build-2784847793"},"reference-count":152,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["31871172"],"award-info":[{"award-number":["31871172"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81870257"],"award-info":[{"award-number":["81870257"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Atrial fibrillation (AF), the most common sustained arrhythmia, is closely intertwined with metabolic abnormalities. Recently, a metabolic paradox in AF pathogenesis has been suggested: under different forms of pathogenesis, the metabolic balance shifts either towards (e.g., obesity and diabetes) or away from (e.g., aging, heart failure, and hypertension) fatty acid oxidation, yet they all increase the risk of AF. This has raised the urgent need for a general consensus regarding the metabolic changes that predispose patients to AF. \u201cMetabolic flexibility\u201d aptly describes switches between substrates (fatty acids, glucose, amino acids, and ketones) in response to various energy stresses depending on availability and requirements. AF, characterized by irregular high-frequency excitation and the contraction of the atria, is an energy challenge and triggers a metabolic switch from preferential fatty acid utilization to glucose metabolism to increase the efficiency of ATP produced in relation to oxygen consumed. Therefore, the heart needs metabolic flexibility. In this review, we will briefly discuss (1) the current understanding of cardiac metabolic flexibility with an emphasis on the specificity of atrial metabolic characteristics; (2) metabolic heterogeneity among AF pathogenesis and metabolic inflexibility as a common pathological basis for AF; and (3) the substrate-metabolism mechanism underlying metabolic inflexibility in AF pathogenesis.<\/jats:p>","DOI":"10.3390\/ijms23158291","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T21:11:05Z","timestamp":1658956265000},"page":"8291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Metabolic Inflexibility as a Pathogenic Basis for Atrial Fibrillation"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-6551","authenticated-orcid":false,"given":"Xinghua","family":"Qin","sequence":"first","affiliation":[{"name":"Xi\u2019an Key Laboratory of Special Medicine and Health Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi\u2019an 710072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiangsun","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update From the GBD 2019 Study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1136\/heartjnl-2020-318480","article-title":"Atrial Fibrillation: Global Burdens and Global Opportunities","volume":"107","author":"Kornej","year":"2021","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1177\/2047487317715769","article-title":"Atrial Fibrillation and the Risk for Myocardial Infarction, All-Cause Mortality and Heart Failure: A Systematic Review and Meta-Analysis","volume":"24","author":"Ruddox","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1161\/01.CIR.98.10.946","article-title":"Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study","volume":"98","author":"Benjamin","year":"1998","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global Epidemiology of Atrial Fibrillation: An Increasing Epidemic and Public Health Challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int. J. Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1161\/CIRCULATIONAHA.116.023163","article-title":"Modifiable Risk Factors and Atrial Fibrillation","volume":"136","author":"Lau","year":"2017","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1210\/er.2017-00211","article-title":"Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease","volume":"39","author":"Smith","year":"2018","journal-title":"Endocr. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3389\/fcvm.2018.00068","article-title":"Loss of Metabolic Flexibility in the Failing Heart","volume":"5","author":"Karwi","year":"2018","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2944","DOI":"10.2337\/diabetes.51.10.2944","article-title":"Dysfunction of Mitochondria in Human Skeletal Muscle in Type 2 Diabetes","volume":"51","author":"Kelley","year":"2002","journal-title":"Diabetes"},{"key":"ref_10","unstructured":"Sperelakis, N., Kurachi, Y., Terzic, A., and Cohen, M.V. (2001). Contributors. Heart Physiology and Pathophysiology, Academic Press. [4th ed.]."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1152\/physrev.1990.70.2.247","article-title":"Ventricular Energetics","volume":"70","author":"Suga","year":"1990","journal-title":"Physiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1161\/CIRCRESAHA.113.302095","article-title":"Cardiac Metabolism and Its Interactions with Contraction, Growth, and Survival of Cardiomyocytes","volume":"113","author":"Kolwicz","year":"2013","journal-title":"Circ. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1146\/annurev.ph.36.030174.002213","article-title":"Relationship between Carbohydrate and Lipid Metabolism and the Energy Balance of Heart Muscle","volume":"36","author":"Neely","year":"1974","journal-title":"Annu. Rev. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/FJC.0b013e3181e74a14","article-title":"Energy Metabolic Phenotype of the Cardiomyocyte during Development, Differentiation, and Postnatal Maturation","volume":"56","author":"Lopaschuk","year":"2010","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1152\/physrev.00006.2004","article-title":"Myocardial Substrate Metabolism in the Normal and Failing Heart","volume":"85","author":"Stanley","year":"2005","journal-title":"Physiol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"24447","DOI":"10.1074\/jbc.M110.100651","article-title":"Adaptation of Myocardial Substrate Metabolism to a Ketogenic Nutrient Environment","volume":"285","author":"Wentz","year":"2010","journal-title":"J. Biol. Chem."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kolb, H., Kempf, K., R\u00f6hling, M., Lenzen-Schulte, M., Schloot, N.C., and Martin, S. (2021). Ketone Bodies: From Enemy to Friend and Guardian Angel. BMC Med., 19.","DOI":"10.1186\/s12916-021-02185-0"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1146\/annurev.bi.49.070180.002143","article-title":"Regulation of Hepatic Fatty Acid Oxidation and Ketone Body Production","volume":"49","author":"McGarry","year":"1980","journal-title":"Annu. Rev. Biochem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1161\/CIRCRESAHA.111.255505","article-title":"AMP-Activated Protein Kinase Regulation and Biological Actions in the Heart","volume":"111","author":"Zaha","year":"2012","journal-title":"Circ. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1172\/JCI10268","article-title":"Peroxisome Proliferator-Activated Receptor Gamma Coactivator-1 Promotes Cardiac Mitochondrial Biogenesis","volume":"106","author":"Lehman","year":"2000","journal-title":"J. Clin. Invest."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"H1","DOI":"10.1152\/ajpheart.01118.2002","article-title":"PPAR-Alpha Effects on the Heart and Other Vascular Tissues","volume":"285","author":"Francis","year":"2003","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s10863-009-9205-y","article-title":"Akt Mediated Mitochondrial Protection in the Heart: Metabolic and Survival Pathways to the Rescue","volume":"41","author":"Miyamoto","year":"2009","journal-title":"J. Bioenerg. Biomembr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.3389\/fendo.2018.00460","article-title":"HIF-1, Metabolism, and Diabetes in the Embryonic and Adult Heart","volume":"9","author":"Cerychova","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1016\/j.bbamcr.2010.08.006","article-title":"Hypoxia-Inducible Factor 1: Regulator of Mitochondrial Metabolism and Mediator of Ischemic Preconditioning","volume":"1813","author":"Semenza","year":"2011","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_25","first-page":"881","article-title":"Left Atrium: No Longer Neglected","volume":"6","author":"Rossi","year":"2005","journal-title":"Ital. Heart J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1038\/s41586-020-2797-4","article-title":"Cells of the Adult Human Heart","volume":"588","author":"Litvinukova","year":"2020","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1161\/CIRCULATIONAHA.107.748053","article-title":"Differential Behaviors of Atrial versus Ventricular Fibroblasts: A Potential Role for Platelet-Derived Growth Factor in Atrial-Ventricular Remodeling Differences","volume":"117","author":"Burstein","year":"2008","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.cardiores.2004.03.026","article-title":"Differences in Atrial versus Ventricular Remodeling in Dogs with Ventricular Tachypacing-Induced Congestive Heart Failure","volume":"63","author":"Hanna","year":"2004","journal-title":"Cardiovasc. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.yjmcc.2008.08.007","article-title":"Marked Differences between Atrial and Ventricular Gene-Expression Remodeling in Dogs with Experimental Heart Failure","volume":"45","author":"Cardin","year":"2008","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00424-005-1404-8","article-title":"Functional Profiling of Human Atrial and Ventricular Gene Expression","volume":"450","author":"Barth","year":"2005","journal-title":"Pflugers Arch."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1161\/01.RES.0000165480.82737.33","article-title":"Reprogramming of the Human Atrial Transcriptome in Permanent Atrial Fibrillation: Expression of a Ventricular-like Genomic Signature","volume":"96","author":"Barth","year":"2005","journal-title":"Circ. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"H494","DOI":"10.1152\/ajpheart.00867.2012","article-title":"Metabolomic Profiling Analysis Reveals Chamber-Dependent Metabolite Patterns in the Mouse Heart","volume":"305","author":"Shimura","year":"2013","journal-title":"Am. J. Physiol. Heart. Circ. Physiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/0022-2828(75)90013-9","article-title":"Comparison of the Adenine Nucleotide Metabolism of Dog Atrial and Ventricular Myocardium","volume":"7","author":"Thomas","year":"1975","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_34","first-page":"1","article-title":"Differences between Atrial and Ventricular Energy-Supplying Enzymes in Five Mammalian Species","volume":"42","author":"Bass","year":"1993","journal-title":"Physiol. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1144.18","DOI":"10.1096\/fasebj.26.1_supplement.1144.18","article-title":"The Manner of Metabolism Is Different between the Atrium and the Ventricle","volume":"26","author":"Shimura","year":"2012","journal-title":"FASEB J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1253\/circj.CJ-17-1058","article-title":"Metabolic Considerations in Atrial Fibrillation\u2015Mechanistic Insights and Therapeutic Opportunities","volume":"81","author":"Harada","year":"2017","journal-title":"Circ. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1016\/j.hrthm.2020.03.025","article-title":"Linking Cellular Energy State to Atrial Fibrillation Pathogenesis: Potential Role of Adenosine Monophosphate\u2013Activated Protein Kinase","volume":"17","author":"Chakraborty","year":"2020","journal-title":"Heart Rhythm"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1111\/j.1540-8167.2010.01718.x","article-title":"Comparative Expression of Proteins in Left and Right Atrial Appendages from Patients with Mitral Valve Disease at Sinus Rhythm and Atrial Fibrillation","volume":"21","author":"Modrego","year":"2010","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7105","DOI":"10.1113\/JP272979","article-title":"The Impacts of Age and Frailty on Heart Rate and Sinoatrial Node Function","volume":"594","author":"Moghtadaei","year":"2016","journal-title":"J. Physiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e008296","DOI":"10.1161\/CIRCEP.120.008296","article-title":"Ion Channel and Structural Remodeling in Obesity-Mediated Atrial Fibrillation","volume":"13","author":"McCauley","year":"2020","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s12933-014-0122-y","article-title":"Sinoatrial Node Dysfunction Induces Cardiac Arrhythmias in Diabetic Mice","volume":"13","author":"Soltysinska","year":"2014","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Malag\u00f9, M., Marchini, F., Fiorio, A., Sirugo, P., Cl\u00f2, S., Mari, E., Gamberini, M.R., Rapezzi, C., and Bertini, M. (2022). Atrial Fibrillation in \u03b2-Thalassemia: Overview of Mechanism, Significance and Clinical Management. Biology, 11.","DOI":"10.3390\/biology11010148"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1001\/jama.292.20.2471","article-title":"Obesity and the Risk of New-Onset Atrial Fibrillation","volume":"292","author":"Wang","year":"2004","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1016\/j.jacc.2010.02.029","article-title":"The Long- and Short-Term Impact of Elevated Body Mass Index on the Risk of New Atrial Fibrillation","volume":"55","author":"Tedrow","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jacep.2015.04.004","article-title":"Obesity and the Risk of Incident, Post-Operative, and Post-Ablation Atrial Fibrillation","volume":"1","author":"Wong","year":"2015","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ebiom.2018.08.034","article-title":"A U-Shaped Relationship of Body Mass Index on Atrial Fibrillation Recurrence Post Ablation: A Report from the Guangzhou Atrial Fibrillation Ablation Registry","volume":"35","author":"Deng","year":"2018","journal-title":"EBioMedicine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1093\/ehjcvp\/pvaa013","article-title":"Obesity and Atrial Fibrillation: Making Inroads through Fat","volume":"7","author":"Javed","year":"2021","journal-title":"Eur. Heart. J. Cardiovasc. Pharmacother."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1111\/j.1467-789X.2010.00812.x","article-title":"Metabolic Flexibility and Obesity in Children and Youth: Metabolic Flexibility in Youth","volume":"12","author":"Aucouturier","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S2213-8587(17)30262-0","article-title":"Risk of Atrial Fibrillation in People with Type 1 Diabetes Compared with Matched Controls from the General Population: A Prospective Case-Control Study","volume":"5","author":"Dahlqvist","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3389\/fphys.2019.00135","article-title":"The Association Between Diabetes Mellitus and Atrial Fibrillation: Clinical and Mechanistic Insights","volume":"10","author":"Bohne","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"835","DOI":"10.3389\/fphys.2018.00835","article-title":"A Machine Learning Aided Systematic Review and Meta-Analysis of the Relative Risk of Atrial Fibrillation in Patients With Diabetes Mellitus","volume":"9","author":"Xiong","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.amjcard.2011.03.004","article-title":"Meta-Analysis of Cohort and Case-Control Studies of Type 2 Diabetes Mellitus and Risk of Atrial Fibrillation","volume":"108","author":"Huxley","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1136\/heartjnl-2011-300503","article-title":"Type 2 Diabetes, Glucose Homeostasis and Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities Study","volume":"98","author":"Huxley","year":"2012","journal-title":"Heart"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.jacc.2012.06.030","article-title":"Type 2 Diabetes Mellitus and Risk of Incident Atrial Fibrillation in Women","volume":"60","author":"Schoen","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1467-789X.2008.00544.x","article-title":"Metabolic Flexibility in the Development of Insulin Resistance and Type 2 Diabetes: Effects of Lifestyle","volume":"10","author":"Corpeleijn","year":"2009","journal-title":"Obes. Rev."},{"key":"ref_56","first-page":"49","article-title":"Atrial Fibrillation in the Elderly","volume":"16","author":"Alfonso","year":"2019","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1093\/eurheartj\/ehi825","article-title":"Prevalence, Incidence and Lifetime Risk of Atrial Fibrillation: The Rotterdam Study","volume":"27","author":"Heeringa","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1016\/j.metabol.2009.12.020","article-title":"The Contribution of Race and Diabetes Status to Metabolic Flexibility in Humans","volume":"59","author":"Stull","year":"2010","journal-title":"Metabolism"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1177\/2047487318768026","article-title":"Physical Activity Volume in Relation to Risk of Atrial Fibrillation. A Non-Linear Meta-Regression Analysis","volume":"25","author":"Ricci","year":"2018","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_60","first-page":"132","article-title":"Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study","volume":"1","author":"Mittal","year":"2008","journal-title":"J. Atr. Fibrillation"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1136\/heartjnl-2019-315327","article-title":"Lifestyle Modifications for Treatment of Atrial Fibrillation","volume":"106","author":"Middeldorp","year":"2020","journal-title":"Heart"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1093\/eurheartj\/ehn579","article-title":"Atrial Fibrillation in Acute Myocardial Infarction: A Systematic Review of the Incidence, Clinical Features and Prognostic Implications","volume":"30","author":"Schmitt","year":"2009","journal-title":"Eur. Heart. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/jama.1994.03510350050036","article-title":"Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort. The Framingham Heart Study","volume":"271","author":"Benjamin","year":"1994","journal-title":"JAMA"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1161\/CIRCULATIONAHA.110.009035","article-title":"Absolute and Attributable Risks of Atrial Fibrillation in Relation to Optimal and Borderline Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"123","author":"Huxley","year":"2011","journal-title":"Circulation"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/europace\/eun369","article-title":"The Registry of the German Competence NETwork on Atrial Fibrillation: Patient Characteristics and Initial Management","volume":"11","author":"Nabauer","year":"2008","journal-title":"Europace"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1161\/CIRCRESAHA.117.311402","article-title":"Hypertension and Atrial Fibrillation: Doubts and Certainties From Basic and Clinical Studies","volume":"122","author":"Verdecchia","year":"2018","journal-title":"Circ. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1161\/ATVBAHA.115.306226","article-title":"Metabolic Flexibility and Dysfunction in Cardiovascular Cells","volume":"35","author":"Vallerie","year":"2015","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.amjmed.2009.06.033","article-title":"Atrial Fibrillation in Heart Failure: A Comprehensive Review","volume":"123","author":"Deedwania","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"28","DOI":"10.15420\/aer.2018.76.2","article-title":"Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities","volume":"8","author":"Vyas","year":"2019","journal-title":"Arrhythm. Electrophysiol. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1038\/ijo.2012.170","article-title":"Myocardial Substrate Metabolism in Obesity","volume":"37","author":"Rider","year":"2013","journal-title":"Int. J. Obes."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.bbalip.2005.03.005","article-title":"Fatty Acid Metabolism Is Enhanced in Type 2 Diabetic Hearts","volume":"1734","author":"Carley","year":"2005","journal-title":"BBA Mol. Cell Biol. Lipids"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"669497","DOI":"10.3389\/fphys.2021.669497","article-title":"Metabolic Complications in Cardiac Aging","volume":"12","author":"Sithara","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1152\/japplphysiol.00698.2011","article-title":"Physical Inactivity as the Culprit of Metabolic Inflexibility: Evidence from Bed-Rest Studies","volume":"111","author":"Bergouignan","year":"2011","journal-title":"J. Appl. Physiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1006\/jmcc.1994.1155","article-title":"Altered Glucose and Fatty Acid Oxidation in Hearts of the Spontaneously Hypertensive Rat","volume":"26","author":"Christe","year":"1994","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1001\/jamacardio.2017.4665","article-title":"Association of of Atrial Fibrillation Clinical Phenotypes With Treatment Patterns and Outcomes: A Multicenter Registry Study","volume":"3","author":"Inohara","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.amjcard.2019.05.071","article-title":"A Cluster Analysis of the Japanese Multicenter Outpatient Registry of Patients With Atrial Fibrillation","volume":"124","author":"Inohara","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_77","first-page":"100885","article-title":"J-RHYTHM Registry Investigators Clinical Phenotypes of Patients with Non-Valvular Atrial Fibrillation as Defined by a Cluster Analysis: A Report from the J-RHYTHM Registry","volume":"37","author":"Watanabe","year":"2021","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1872-034X.2011.00787.x","article-title":"Alcohol Consumption and Metabolic Syndrome: Alcohol and Metabolic Syndrome","volume":"41","author":"Fujita","year":"2011","journal-title":"Hepatol. Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1056\/NEJMoa1817591","article-title":"Alcohol Abstinence in Drinkers with Atrial Fibrillation","volume":"382","author":"Voskoboinik","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2015.04.058","article-title":"Electrophysiological, Electroanatomical, and Structural Remodeling of the Atria as Consequences of Sustained Obesity","volume":"66","author":"Mahajan","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"771940","DOI":"10.3389\/fphar.2021.771940","article-title":"Enhancing Fatty Acids Oxidation via L-Carnitine Attenuates Obesity-Related Atrial Fibrillation and Structural Remodeling by Activating AMPK Signaling and Alleviating Cardiac Lipotoxicity","volume":"12","author":"Zhang","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_82","first-page":"1","article-title":"High Fat Diet Induced Alterations of Atrial Electrical Activities in Mice","volume":"6","author":"Zhang","year":"2016","journal-title":"Am. J. Cardiovasc. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1161\/01.RES.80.6.772","article-title":"Outward K + Current Densities and Kv1.5 Expression Are Reduced in Chronic Human Atrial Fibrillation","volume":"80","author":"Pond","year":"1997","journal-title":"Circ. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1113\/JP276390","article-title":"K V 1.5 Channel Down-regulation in Pulmonary Hypertension Is Nothing Short of MiR-1-aculous!","volume":"597","author":"Aaronson","year":"2019","journal-title":"J. Physiol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3389\/fphys.2017.00431","article-title":"Cardiac Ion Channel Regulation in Obesity and the Metabolic Syndrome: Relevance to Long QT Syndrome and Atrial Fibrillation","volume":"8","author":"Aromolaran","year":"2017","journal-title":"Front. Physiol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s11606-010-1340-y","article-title":"Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation","volume":"25","author":"Dublin","year":"2010","journal-title":"J. Gen. Intern. Med."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Qi, W., Zhang, N., Korantzopoulos, P., Letsas, K.P., Cheng, M., Di, F., Tse, G., Liu, T., and Li, G. (2017). Serum Glycated Hemoglobin Level as a Predictor of Atrial Fibrillation: A Systematic Review with Meta-Analysis and Meta-Regression. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170955"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/cvr\/cvu176","article-title":"Glucose Fluctuations Increase the Incidence of Atrial Fibrillation in Diabetic Rats","volume":"104","author":"Saito","year":"2014","journal-title":"Cardiovasc. Res."},{"key":"ref_89","first-page":"410","article-title":"Impact of Long-Term Glycemic Variability on Development of Atrial Fibrillation in Type 2 Diabetic Patients","volume":"18","author":"Gu","year":"2017","journal-title":"Anatol. J. Cardiol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/j.amjcard.2010.07.038","article-title":"Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation Associated With Diabetes Mellitus or Impaired Fasting Glucose","volume":"106","author":"Chao","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1177\/2047487320908706","article-title":"Association between Insulin Resistance and Risk of Atrial Fibrillation in Non-Diabetics","volume":"27","author":"Lee","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Johnson, L.S., Juhlin, T., Engstr\u00f6m, G., and Nilsson, P.M. (2014). Low Fasting Plasma Insulin Is Associated with Atrial Fibrillation in Men from a Cohort Study\u2014The Malm\u00f6 Preventive Project. BMC Cardiovasc. Disord., 14.","DOI":"10.1186\/1471-2261-14-107"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.amjcard.2011.08.008","article-title":"Insulin Resistance and Atrial Fibrillation (from the Framingham Heart Study)","volume":"109","author":"Fontes","year":"2012","journal-title":"Am. J. Cardiol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.numecd.2018.02.016","article-title":"Fasting and Post-Glucose Load Measures of Insulin Resistance and Risk of Incident Atrial Fibrillation: The Cardiovascular Health Study","volume":"28","author":"Garg","year":"2018","journal-title":"Nutr. Metab. Cardiovasc."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12933-019-0928-8","article-title":"Atrial Fibrillation and Its Arrhythmogenesis Associated with Insulin Resistance","volume":"18","author":"Chan","year":"2019","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"7990","DOI":"10.1073\/pnas.1914853117","article-title":"Loss of Insulin Signaling May Contribute to Atrial Fibrillation and Atrial Electrical Remodeling in Type 1 Diabetes","volume":"117","author":"Polina","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3389\/fcvm.2020.00134","article-title":"Insulin Treatment Reduces Susceptibility to Atrial Fibrillation in Type 1 Diabetic Mice","volume":"7","author":"Maria","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.bbadis.2017.12.038","article-title":"Dysregulation of Insulin-Sensitive Glucose Transporters During Insulin Resistance-Induced Atrial Fibrillation","volume":"1864","author":"Maria","year":"2018","journal-title":"BBA Mol. Basis Dis."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.cca.2019.08.029","article-title":"The Warburg Effect: A New Insight into Atrial Fibrillation","volume":"499","author":"Liu","year":"2019","journal-title":"Clin. Chim. Acta"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1743-7075-11-10","article-title":"The Pivotal Role of Pyruvate Dehydrogenase Kinases in Metabolic Flexibility","volume":"11","author":"Zhang","year":"2014","journal-title":"Nutr. Metab."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Tao, R., Xiong, X., Harris, R.A., White, M.F., and Dong, X.C. (2013). Genetic Inactivation of Pyruvate Dehydrogenase Kinases Improves Hepatic Insulin Resistance Induced Diabetes. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0071997"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.bbrc.2019.06.055","article-title":"Regulating the Warburg Effect on Metabolic Stress and Myocardial Fibrosis Remodeling and Atrial Intracardiac Waveform Activity Induced by Atrial Fibrillation","volume":"516","author":"Hu","year":"2019","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1152\/jappl.1997.83.1.166","article-title":"Altered Glycolytic and Oxidative Capacities of Skeletal Muscle Contribute to Insulin Resistance in NIDDM","volume":"83","author":"Simoneau","year":"1997","journal-title":"J. Appl. Physiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S2213-8587(14)70146-9","article-title":"Differences in the Prospective Association between Individual Plasma Phospholipid Saturated Fatty Acids and Incident Type 2 Diabetes: The EPIC-InterAct Case-Cohort Study","volume":"2","author":"Forouhi","year":"2014","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"19621","DOI":"10.1039\/C9RA10684G","article-title":"A Metabolomic Study for Chronic Heart Failure Patients Based on a Dried Blood Spot Mass Spectrometry Approach","volume":"10","author":"Zhao","year":"2020","journal-title":"RSC Adv."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/acel.12416","article-title":"Age-Associated Changes in Long-Chain Fatty Acid Profile during Healthy Aging Promote pro-Inflammatory Monocyte Polarization via PPARgamma","volume":"15","author":"Pararasa","year":"2016","journal-title":"Aging Cell"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e000889","DOI":"10.1161\/JAHA.114.000889","article-title":"Plasma Phospholipid Saturated Fatty Acids and Incident Atrial Fibrillation: The Cardiovascular Health Study","volume":"3","author":"Fretts","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e012853","DOI":"10.1161\/JAHA.119.012853","article-title":"Plasma Ceramides and Sphingomyelins in Relation to Atrial Fibrillation Risk: The Cardiovascular Health Study","volume":"9","author":"Jensen","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1007\/s00018-011-0690-x","article-title":"Subcellular Trafficking of the Substrate Transporters GLUT4 and CD36 in Cardiomyocytes","volume":"68","author":"Steinbusch","year":"2011","journal-title":"Cell Mol. Life Sci."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s00395-015-0497-2","article-title":"Arrhythmia Causes Lipid Accumulation and Reduced Glucose Uptake","volume":"110","author":"Lenski","year":"2015","journal-title":"Basic Res. Cardiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1161\/CIRCULATIONAHA.107.712901","article-title":"CD36 Expression Contributes to Age-Induced Cardiomyopathy in Mice","volume":"116","author":"Koonen","year":"2007","journal-title":"Circulation"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jjcc.2017.07.003","article-title":"Decreased Gene Expression of Fatty Acid Binding Protein 3 in the Atrium of Patients with New Onset of Atrial Fibrillation in Cardiac Perioperative Phase","volume":"71","author":"Shingu","year":"2018","journal-title":"J. Cardiol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1253\/circj.CJ-13-1365","article-title":"Quantitative Proteomics of Changes in Energy Metabolism-Related Proteins in Atrial Tissue from Valvular Disease Patients with Permanent Atrial Fibrillation","volume":"78","author":"Tu","year":"2014","journal-title":"Circ. J."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.bbalip.2016.02.016","article-title":"Lipid Metabolism and Signaling in Cardiac Lipotoxicity","volume":"1861","author":"Nzirorera","year":"2016","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"E1193","DOI":"10.1152\/ajpendo.00227.2019","article-title":"Cardiac Overexpression of Perilipin 2 Induces Atrial Steatosis, Connexin 43 Remodeling, and Atrial Fibrillation in Aged Mice","volume":"317","author":"Sato","year":"2019","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.imr.2013.09.004","article-title":"Exercise and Obesity-Induced Insulin Resistance in Skeletal Muscle","volume":"2","author":"Kwak","year":"2013","journal-title":"Integr. Med. Res."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/2339584","article-title":"A \u201cWeird\u201d Mitochondrial Fatty Acid Oxidation as a Metabolic \u201cSecret\u201d of Cancer","volume":"2022","author":"Zhelev","year":"2022","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"3E","DOI":"10.1016\/j.amjcard.2008.02.064","article-title":"More than Bricks and Mortar: Comments on Protein and Amino Acid Metabolism in the Heart","volume":"101","author":"Taegtmeyer","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Nie, C., He, T., Zhang, W., Zhang, G., and Ma, X. (2018). Branched Chain Amino Acids: Beyond Nutrition Metabolism. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19040954"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.freeradbiomed.2021.11.043","article-title":"Activation of PKG-CREB-KLF15 by Melatonin Attenuates Angiotensin II-Induced Vulnerability to Atrial Fibrillation via Enhancing Branched-Chain Amino Acids Catabolism","volume":"178","author":"Yu","year":"2022","journal-title":"Free Radical Biol. Med."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"H1160","DOI":"10.1152\/ajpheart.00114.2016","article-title":"Defective Branched Chain Amino Acid Catabolism Contributes to Cardiac Dysfunction and Remodeling Following Myocardial Infarction","volume":"311","author":"Wang","year":"2016","journal-title":"Am. J. Physiol. Heart C"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1161\/CIRCULATIONAHA.115.020226","article-title":"Catabolic Defect of Branched-Chain Amino Acids Promotes Heart Failure","volume":"133","author":"Sun","year":"2016","journal-title":"Circulation"},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Yoon, M.-S. (2016). The Emerging Role of Branched-Chain Amino Acids in Insulin Resistance and Metabolism. Nutrients, 8.","DOI":"10.3390\/nu8070405"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1038\/nrendo.2014.171","article-title":"Branched-Chain Amino Acids in Metabolic Signalling and Insulin Resistance","volume":"10","author":"Lynch","year":"2014","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_125","first-page":"27","article-title":"The Metabolism of the Heart","volume":"50","author":"Bing","year":"1954","journal-title":"Harvey Lect."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/BF01483852","article-title":"On the Significance of Acetoacetate and Beta-Hydroxybutyrate in Human Myocardial Metabolism","volume":"43","author":"Rudolph","year":"1965","journal-title":"Klin. Wochenschr."},{"key":"ref_127","doi-asserted-by":"crossref","unstructured":"Harvey, K.L., Holcomb, L.E., and Kolwicz, S.J. (2019). Ketogenic Diets and Exercise Performance. Nutrients, 11.","DOI":"10.3390\/nu11102296"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1046\/j.1365-2796.1997.00187.x","article-title":"Heart Failure Ketosis","volume":"242","author":"Lommi","year":"1997","journal-title":"J. Intern. Med."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/0735-1097(96)00214-8","article-title":"Blood Ketone Bodies in Congestive Heart Failure","volume":"28","author":"Lommi","year":"1996","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_130","first-page":"739","article-title":"Studies on Myocardial Blood Flow, Oxygen Consumption, and Myocardial Metabolism in Patients with Cardiomyopathy","volume":"2","author":"Rudolph","year":"1973","journal-title":"Recent Adv. Stud. Cardiac. Struct. Metab."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.jacc.2007.09.055","article-title":"Combined Metabolomic and Proteomic Analysis of Human Atrial Fibrillation","volume":"51","author":"Mayr","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"H1968","DOI":"10.1152\/ajpheart.00250.2002","article-title":"Dl-3-Hydroxybutyrate Administration Prevents Myocardial Damage after Coronary Occlusion in Rat Hearts","volume":"283","author":"Zou","year":"2002","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1096\/fasebj.9.8.7768357","article-title":"Insulin, Ketone Bodies, and Mitochondrial Energy Transduction","volume":"9","author":"Sato","year":"1995","journal-title":"FASEB J."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1210\/er.2019-00034","article-title":"The Liver as an Endocrine Organ\u2014Linking NAFLD and Insulin Resistance","volume":"40","author":"Watt","year":"2019","journal-title":"Endocr. Rev."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"e230","DOI":"10.1038\/nutd.2016.36","article-title":"Short-Term Safety, Tolerability and Efficacy of a Very Low-Calorie-Ketogenic Diet Interventional Weight Loss Program versus Hypocaloric Diet in Patients with Type 2 Diabetes Mellitus","volume":"6","author":"Goday","year":"2016","journal-title":"Nutr. Diabetes"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"E552","DOI":"10.1152\/ajpendo.00453.2013","article-title":"Long-Term Ketogenic Diet Causes Glucose Intolerance and Reduced \u03b2- and \u03b1-Cell Mass but No Weight Loss in Mice","volume":"306","author":"Ellenbroek","year":"2014","journal-title":"Am. J. Physiol. Endocr. Metab."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"8030","DOI":"10.1073\/pnas.1016088108","article-title":"Short-Chain Fatty Acids and Ketones Directly Regulate Sympathetic Nervous System via G Protein-Coupled Receptor 41 (GPR41)","volume":"108","author":"Kimura","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1038\/s41392-020-00411-4","article-title":"Ketogenic Diets Inhibit Mitochondrial Biogenesis and Induce Cardiac Fibrosis","volume":"6","author":"Xu","year":"2021","journal-title":"Signal Transduct. Target Ther."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1042\/bj20021617","article-title":"Ketone Bodies Disturb Fatty Acid Handling in Isolated Cardiomyocytes Derived from Control and Diabetic Rats","volume":"371","author":"Hasselbaink","year":"2003","journal-title":"Biochem. J."},{"key":"ref_140","first-page":"H701","article-title":"Competition between Palmitate and Ketone Bodies as Fuels for the Heart: Study with Positron Emission Tomography","volume":"264","author":"Vanoverschelde","year":"1993","journal-title":"Am. J. Physiol."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"598","DOI":"10.2337\/db16-0530","article-title":"Enhanced Muscle Insulin Sensitivity After Contraction\/Exercise Is Mediated by AMPK","volume":"66","author":"Birk","year":"2017","journal-title":"Diabetes"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"e001733","DOI":"10.1161\/JAHA.114.001733","article-title":"LKB1 Knockout Mouse Develops Spontaneous Atrial Fibrillation and Provides Mechanistic Insights Into Human Disease Process","volume":"4","author":"Ozcan","year":"2015","journal-title":"JAHA"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1111\/jce.14954","article-title":"Effect of Metformin on Outcomes of Catheter Ablation for Atrial Fibrillation","volume":"32","author":"Deshmukh","year":"2021","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"e009115","DOI":"10.1161\/CIRCEP.120.009115","article-title":"Metformin Is Associated With a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared With Sulfonylureas: An Observational Study","volume":"14","author":"Ostropolets","year":"2021","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1111\/bph.13438","article-title":"Fenofibrate Inhibits Atrial Metabolic Remodelling in Atrial Fibrillation through PPAR-Alpha\/Sirtuin 1\/PGC-1alpha Pathway","volume":"173","author":"Liu","year":"2016","journal-title":"Br. J. Pharmacol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1159\/000331717","article-title":"Activation of Beta(3)-Adrenoceptor Promotes Rapid Pacing-Induced Atrial Electrical Remodeling in Rabbits","volume":"28","author":"Yu","year":"2011","journal-title":"Cell Physiol. Biochem."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12944-019-1059-7","article-title":"Metformin Regulates Lipid Metabolism in a Canine Model of Atrial Fibrillation through AMPK\/PPAR-Alpha\/VLCAD Pathway","volume":"18","author":"Bai","year":"2019","journal-title":"Lipids Health Dis."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/s12265-020-10069-6","article-title":"Activation of AMP-Activated Protein Kinases Prevents Atrial Fibrillation","volume":"14","author":"Ozcan","year":"2021","journal-title":"J. Cardiovasc. Trans. Res."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.cmet.2017.04.015","article-title":"Metabolic Flexibility in Health and Disease","volume":"25","author":"Goodpaster","year":"2017","journal-title":"Cell Metab."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1093\/europace\/euy117","article-title":"PREVEntion and RegReSsive Effect of Weight-Loss and Risk Factor Modification on Atrial Fibrillation: The REVERSE-AF Study","volume":"20","author":"Middeldorp","year":"2018","journal-title":"Europace"},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3389\/fimmu.2018.00141","article-title":"A Role for the Krebs Cycle Intermediate Citrate in Metabolic Reprogramming in Innate Immunity and Inflammation","volume":"9","author":"Williams","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1136\/heartjnl-2018-314267","article-title":"Mechanisms of Atrial Fibrillation","volume":"105","author":"Wijesurendra","year":"2019","journal-title":"Heart"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/15\/8291\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:57:33Z","timestamp":1760140653000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/15\/8291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,27]]},"references-count":152,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["ijms23158291"],"URL":"https:\/\/doi.org\/10.3390\/ijms23158291","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,27]]}}}