Stimulant Drugs of Abuse and Cardiac Arrhythmias.
Stimulant Drugs of Abuse and Cardiac Arrhythmias.
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DOI：
10.1161/circep.121.010273
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Olshansky B
中科院分区：
文献类型：
--
作者：
Dominic P;Ahmad J;Awwab H;Bhuiyan MS;Kevil CG;Goeders NE;Murnane KS;Patterson JC;Sandau KE;Gopinathannair R;Olshansky B
处方药和非处方药的非医疗使用是一种世界性流行病，其规模迅速增长，由于过量和长期使用而导致死亡。这些药物中的绝大多数是兴奋剂，对心血管系统（包括心律）有各种影响。药物，如可卡因和甲基苯丙胺，已经测量了对传导系统的影响，并通过几个直接和间接的途径，利用多个第二信使系统，改变心脏的结构和电基质，从而促进心律失常。取代的安非他明和可卡因影响多种离子通道和钙信号蛋白的表达和激活动力学，导致EKG变化以及心房和心室布雷迪和快速性心律失常。预先存在的疾病导致心脏中的底物变化，这降低了这种药物诱导的心律失常的阈值。滥用药物患者心律失常的治疗可能是专门的，需要了解独特的潜在机制，并需要多学科的方法。在慢性收缩性心力衰竭药物滥用者中使用一级或二级预防药物既敏感又有争议。本文综述了与兴奋剂滥用相关的心律失常及其管理。
Non-medical use of prescription and non-prescription drugs is a worldwide epidemic, rapidly growing in magnitude with deaths due to overdose and chronic use. A vast majority of these drugs are stimulants that have various effects on the cardiovascular system including the cardiac rhythm. Drugs, like cocaine and methamphetamine, have measured effects on the conduction system and through several direct and indirect pathways, utilizing multiple second messenger systems, change the structural and electrical substrate of the heart, thereby promoting cardiac dysrhythmias. Substituted amphetamines and cocaine affect the expression and activation kinetics of multiple ion channels and calcium signaling proteins resulting in EKG changes, and atrial and ventricular brady and tachyarrhythmias. Pre-existing conditions cause substrate changes in the heart which decrease the threshold for such drug-induced cardiac arrhythmias. The treatment of cardiac arrhythmias in patients who take drugs of abuse may be specialized and will require an understanding of the unique underlying mechanisms and necessitates a multi-disciplinary approach. The use of primary or secondary prevention defibrillators in drug abusers with chronic systolic heart failure is both sensitive and controversial. This review provides a broad overview of cardiac arrhythmias associated with stimulant substance abuse and their management.
影响因子：
4.2
作者：
Sanchez EJ;Hayes RP;Barr JT;Lewis KM;Webb BN;Subramanian AK;Nissen MS;Jones JP;Shelden EA;Sorg BA;Fill M;Schenk JO;Kang C
通讯作者：
Kang C
影响因子：
0.7
作者：
Ouali S;Guermazi O;Ben Halima M;Boudiche S;Khedher N;Adeljalil F;Meghaeith F;Larbi N;Mourali MS
通讯作者：
Mourali MS