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心房颤动是临床最常见的心律失常之一,糖尿病促进心房颤动的发生近年引起重视;但糖尿病导致心房颤动的分子机制仍不清楚.对于在心房颤动发生发展中发挥关键作用的心房重构,目前仍不清楚是糖尿病直接影响心房组织还是通过其他途径参与了心房重构.既往,糖尿病对心肌重构的影响主要是集中于左心室,对左心房影响的研究很少.新近,左心房功能对左心室舒张功能不全的影响以及左心房在心房-心室偶联中的作用,引起了广泛关注.随着电生理技术的进步,新的超声技术如二维斑点跟踪成像技术的应用,为研究左心房功能提供了更精确、更敏感和更可靠的信息,使进一步阐明糖尿病时心房重构和相关心房颤动的发生机制成为可能.现就近年来糖尿病致心房重构的分子机制及临床治疗进展进行综述.“,”Atrial fibrillation is one of the most common arrhythmias in clinical practice.The incidence of atrial fibrillation with diabetes has drawn great attention in recent years.However,the molecular mechanism of diabetes leading to atrial fibrillation remains unclear. For atrial remodeling that plays a key role in the development of atrial fibrillation,it remains unclear whether diabetes affects atrial tissue directly or through other pathways involved in atrial remodeling.In the past,the impact of diabetes on myocardial remodeling is mainly focused on the left ventricle,the study of the impact on the left atrium is few.Recently,the left atrial function on left ventricular diastolic dysfunction and left atrial function in atrial-ventricular coupling,aroused widespread concern.With the advancement of electrophysiological techniques,the application of new ultrasound techniques such as two-dimensional speckle tracking imaging provides more accurate,sensitive and reliable information for the study of left atrial function.It is possible that further clarifying the role of atrial remodeling and related to the mechanism of occurrence of atrial fibrillation.This review summarizes the molecular mechanisms of atrial remodeling caused by diabetes and clinical progress in recent years.