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已发表论文
胰高糖素样肽-1 受体激动剂（GLP-1RAs）的潜在抗心律失常机制
Authors Li J , Fu K, Zhao J, Zou Y, Li L, Huang Q, Long L, Ou X , Lei M, Zhang C, Tan X, Chen T
Received 5 November 2025
Accepted for publication 16 January 2026
Published 8 February 2026 Volume 2026:20 579419
DOI https://doi.org/10.2147/DDDT.S579419
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Jianhong Li,1,2,* Kun Fu,1,2,* Jiaqian Zhao,1,3,* Ying Zou,1 Li Li,1 Qiuyuan Huang,1 Limei Long,1,2 Xianhong Ou,1 Ming Lei,4 Chunxiang Zhang,1,2 Xiaoqiu Tan,1– 3 Tangting Chen1,2
1Key Laboratory of Medical Electrophysiology of the Ministry of Education, Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 2Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 3Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 4Department of Pharmacology, University of Oxford, Oxford, UK
*These authors contributed equally to this work
Correspondence: Tangting Chen, Email ctt@swmu.edu.cn Xiaoqiu Tan, Email tanxiaoqiu@swmu.edu.cn
Abstract: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel class of glucose-lowering agents that offer benefits beyond glycemic control and weight loss and are increasingly recognized for their cardioprotective benefits, including protective effects against hypertension, heart failure, myocardial infarction, and arrhythmias. Notably, GLP-1RAs have demonstrated a significant capacity to reduce arrhythmia risk not only in animal models but also in large-scale clinical trials. However, the antiarrhythmic mechanisms of GLP-1RAs remain incompletely understood. This mechanistic review synthesizes current preclinical and clinical evidence to delineate the key pathways through which GLP-1RAs may exert their antiarrhythmic effects. The primary mechanisms discussed include the attenuation of cardiomyocyte death, improvement of myocardial metabolism, and inhibition of the inflammatory response. Additional mechanisms, such as the promotion of autophagy, maintenance of ion homeostasis in cardiomyocytes, and modulation of the autonomic nervous system, are also examined. By clarifying these mechanisms, this review aims to offer novel therapeutic strategies for arrhythmia prevention, especially in the high-risk population with cardiometabolic diseases.
Keywords: glucagon-like peptide-1 receptor agonists, antiarrhythmic, liraglutide, exendin-4, semaglutide
1Key Laboratory of Medical Electrophysiology of the Ministry of Education, Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 2Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 3Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 4Department of Pharmacology, University of Oxford, Oxford, UK
*These authors contributed equally to this work
Correspondence: Tangting Chen, Email ctt@swmu.edu.cn Xiaoqiu Tan, Email tanxiaoqiu@swmu.edu.cn
Abstract: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel class of glucose-lowering agents that offer benefits beyond glycemic control and weight loss and are increasingly recognized for their cardioprotective benefits, including protective effects against hypertension, heart failure, myocardial infarction, and arrhythmias. Notably, GLP-1RAs have demonstrated a significant capacity to reduce arrhythmia risk not only in animal models but also in large-scale clinical trials. However, the antiarrhythmic mechanisms of GLP-1RAs remain incompletely understood. This mechanistic review synthesizes current preclinical and clinical evidence to delineate the key pathways through which GLP-1RAs may exert their antiarrhythmic effects. The primary mechanisms discussed include the attenuation of cardiomyocyte death, improvement of myocardial metabolism, and inhibition of the inflammatory response. Additional mechanisms, such as the promotion of autophagy, maintenance of ion homeostasis in cardiomyocytes, and modulation of the autonomic nervous system, are also examined. By clarifying these mechanisms, this review aims to offer novel therapeutic strategies for arrhythmia prevention, especially in the high-risk population with cardiometabolic diseases.
Keywords: glucagon-like peptide-1 receptor agonists, antiarrhythmic, liraglutide, exendin-4, semaglutide