Molecular mechanisms of heart failure progression associated with implantable cardioverter-defibrillator shocks for ventricular tachyarrhythmias.
Molecular mechanisms of heart failure progression associated with implantable cardioverter-defibrillator shocks for ventricular tachyarrhythmias.
复制标题
室性快速心律失常与植入式心脏复律除颤器电击相关的心力衰竭进展的分子机制。
DOI：
10.1016/j.joa.2014.04.003
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Makita N.
中科院分区：
文献类型：
--
作者：
Tsuji Y;Ishikawa T;Makita N.
植入式心律转复除颤器（ICD）在降低室性快速性心律失常（VTA）相关死亡率方面非常有效。尽管有这种益处，但在心力衰竭（HF）和左心室功能低下的患者中发生ICD电击治疗VTA与不良结局相关。患有休克性VTA的患者发生HF和死亡的风险升高。虽然VTA可能是高危患者的标志物，但电击和VTA的有害影响可能与HF进展和相关死亡率有关。一些研究人员推测，休克VTA可能激活HF分子级联中的信号通路。我们最近在一个室颤风暴的实验模型中报道，多次ICD电击治疗复发性室颤引起了Ca 2 +/钙调素依赖性蛋白激酶II（一种经验证的HF信号分子）的显著激活。这篇综述文章描述了休克和VTA的有害影响，并提出Ca 2 +/钙调蛋白依赖性蛋白激酶II可能将休克VTA与不良结局联系起来。
Implantable cardioverter-defibrillators (ICDs) are highly effective in reducing mortality related to ventricular tachyarrhythmias (VTAs). Despite this benefit, the occurrence of ICD shocks for VTAs in patients with heart failure (HF) and depressed left ventricular function has been associated with adverse outcomes. Patients with shocked VTAs are at an elevated risk of HF and death. While VTAs may be markers for high-risk patients, it is possible that the harmful effects of electrical shocks and VTAs are involved in HF progression and associated mortality. Some investigators have speculated that shocked VTAs may activate signaling pathways in the molecular cascade of HF. We recently reported in an experimental model of ventricular fibrillation storm that multiple ICD shocks for recurrent ventricular fibrillation caused striking activation of Ca2+/calmodulin-dependent protein kinase II, a validated signaling molecule for HF. This review article describes the harmful effects of shocks and VTAs and proposes that Ca2+/calmodulin-dependent protein kinase II could connect shocked VTAs to adverse outcomes.