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Table 1 Effects of metformin on atrial arrhythmias: reports from in vitro studies

From: Effects of metformin on atrial and ventricular arrhythmias: evidence from cell to patient

Model

Metformin (dose/ duration)

Key results and major findings

Interpretation

References

Energy homeostasis

Oxidative stress

Intra-cellular Ca

Inflammation

Cx43

EP changes

Cell structure

HL-1 atrial cells paced with 4 Hz (240 bpm) for 24 h

1 mmol/L for 2 h

–

↓ROS

–

–

–

–

↑Cytoplasmic myosin heavy chain/nuclear area ratio

↑Troponin I

Metformin provided cardioprotection against AF-related adverse remodeling via attenuating tachy-induced myolysis and oxidative stress of atria cells

[44]

Neonatal rat cardiomyocytes and HL-1 cell with field stimulation at 3 Hz for 12 h

0.5 & 1

mmol/L

↓cAMP→

↓pSrc→

↑AMPK→

↑Cx43

–

–

–

↑

↑FPD

↑ZO-1

Metformin attenuated a shortened FPD possibly by improved gap junction function via AMPK activation, increased ZO-1 and Cx43 expression

[42]

3T3-L1 mature adipocytes with LPS for 24 h then co-cultured with HL-1 atrial cell

4 mmol/L incubated with adipocytes for 12 h

–

–

↓Ca, ↑SERCA2a, ↑pPLN in HL-1 cell

↑PPARγ/ APN, and ↓TNFα in adipocytes

–

–

–

Metformin improved Ca2+ homeostasis in HL-1 cell by attenuated the inflammatory interaction between adipocytes and HL-1 cell via an increased PPARγ/APN and suppressed TNFα

[45]

  1. AMPK 5' adenosine monophosphate-activated protein kinase, APN adiponectin, Ca calcium, cAMP cyclic adenosine monophosphate, Cx43 connexin 43, FPD field potential duration, LPS lipopolysaccharide, PPARγ peroxisome proliferator-activated receptor gamma, pPLN phosphorylated phospholamban, p-Src phopho-Src(Tyr416), ROS reactive oxygen species, SERCA2a sarcoplasmic reticulum Ca2+-ATPase2a, TNFα tumor necrosis factor alpha, ZO-1 Zonula occludens-1