Structural and functional basis for the long QT syndrome: relevance to veterinary patients.
Structural and functional basis for the long QT syndrome: relevance to veterinary patients.
复制标题
长 QT 综合征的结构和功能基础：与兽医患者的相关性。
DOI：
10.1111/j.1939-1676.2003.tb02468.x
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发表时间：
2003
影响因子：
2.6
通讯作者：
Freeman,LisaC
中科院分区：
文献类型：
--
作者：
Finley,MelissaR;Lillich,JamesD;GilmourJr,RobertF;Freeman,LisaC
长QT综合征（LQTS）是一种以心室复极延长为特征的疾病，临床表现为体表心电图QT间期延长。尽管与编码离子通道蛋白的基因突变相关的遗传形式的LQTS仅在人类中被鉴定，但获得形式的LQTS发生在人类和伴侣动物物种中。通常，获得性LQTS与药物诱导的心脏K+电流阻滞（称为IKr）相关。然而，并不是所有诱导潜在致命性室性心律失常的药物都能拮抗IKr，也不是所有阻断与室性心律失常相关的IKrare的药物都能拮抗IKr。在临床实践中，QT间期延长的程度和室性心律失常的风险与IKrare的拮抗作用有关，受药代动力学和药效学变量的调节。兽医可以影响一些潜在的风险因素（例如，药物剂量、给药途径、有无伴随药物治疗和患者电解质状态），但不是所有因素（例如，患者性别/遗传背景）。兽医需要意识到在使用HERG通道和IKr阻断剂治疗期间获得性LQTS的可能性。
Long QT syndrome (LQTS) is a condition characterized by prolongation of ventricular repolarization and is manifested clinically by lengthening of the QT interval on the surface ECG. Whereas inherited forms of LQTS associated with mutations in the genes that encode ion channel proteins are identified only in humans, the acquired form of LQTS occurs in humans and companion animal species. Often, acquired LQTS is associated with drug‐induced block of the cardiac K+current designated IKr. However, not all drugs that induce potentially fatal ventricular arrhythmias antagonize IKr, and not all drugs that block IKrare associated with ventricular arrhythmias. In clinical practice, the extent of QT interval prolongation and risk of ventricular arrhythmia associated with antagonism of IKrare modulated by pharmacokinetic and pharmacodynamic variables. Veterinarians can influence some of the potential risk factors (eg, drug dosage, route of drug administration, presence or absence of concurrent drug therapy, and patient electrolyte status) but not all (eg, patient gender/genetic background). Veterinarians need to be aware of the potential for acquired LQTS during therapy with drugs identified as blockers of HERG channels and IKr.