Unmasking of Brugada syndrome by lithium
Unmasking of Brugada syndrome by lithium
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DOI：
10.1161/circulationaha.105.548487
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发表时间：
2005-09-13
期刊：
影响因子：
37.8
通讯作者：
Roden, DM
中科院分区：
文献类型：
--
作者：
Darbar, D;Yang, T;Roden, DM
背景--Brugada综合征的特征性心电图表现为V-1和V-2导联ST段抬高，是动态的;在受累个体中常间歇性出现，可被钠通道阻滞剂（包括抗心律失常药物和三环类抗抑郁药）所掩盖。我们在这里报告2例谁开发的Brugada心电图模式后，管理锂，一种常用的药物，以前没有报道，以阻止心脏sodium channels.Methods和Results -锂诱导的短暂ST段抬高（1型Brugada模式）在右胸导联治疗浓度在2例双相情感障碍。患者停用锂盐后可逆转为2型或3型Brugada模式或ST- T异常消退。在用编码心脏钠通道的SCN 5A转染的中国仓鼠卵巢细胞中，氯化锂在远低于治疗范围的水平（IC 50为6.8 +/- 0.4 μ mol/ L）引起峰值INa的浓度依赖性阻断。
Background - The characteristic ECG pattern of ST- segment elevation in V-1 and V-2 in the Brugada syndrome is dynamic; it is often intermittently present in affected individuals and can be unmasked by sodium channel blockers, including antiarrhythmic drugs and tricyclic antidepressants. We report here 2 patients who developed the Brugada ECG pattern after administration of lithium, a commonly used drug not previously reported to block cardiac sodium channels.Methods and Results - Lithium induced transient ST- segment elevation ( type 1 Brugada pattern) in right precordial leads at therapeutic concentrations in 2 patients with bipolar disorder. Lithium withdrawal in the patients resulted in reversion to type 2 or 3 Brugada patterns or resolution of ST- T abnormalities. In Chinese hamster ovary cells transfected with SCN5A, which encodes the cardiac sodium channel, lithium chloride caused concentration- dependent block of peak INa at levels well below the therapeutic range ( IC50 of 6.8 +/- 0.4 mu mol/ L).Conclusions - The widely used drug lithium is a potent blocker of cardiac sodium channels and may unmask patients with the Brugada syndrome.