Kaiser Lana, Davis John M, Patterson Jon, Johnson Abby L, Bohart George, Olivier N Bari, Schwartz Kenneth A
Hematology & Oncology Unit, Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Transl Res. 2009 Oct;154(4):202-13. doi: 10.1016/j.trsl.2009.07.002. Epub 2009 Jul 31.
Chronic iron overload associated with hereditary hemochromatosis or repeated red cell transfusions is known to cause cardiac failure. Cardiac arrhythmias have been incidentally noted in patients with iron overload, but they are often dismissed as being related to comorbid conditions. Studies with anesthetized iron-loaded gerbils using short recordings suggest a role for iron in the development of arrhythmias. Our goal was to characterize iron-induced arrhythmias in the chronically instrumented, untethered, telemetered gerbil. Electrocardiograms were recorded for 10 s every 30 min for approximately 6 months in iron-loaded (n=23) and control (n=8) gerbils. All gerbils in both groups showed evidence of frequent sinus arrhythmia. There was no difference in heart rate, electrocardiographic parameters, or number of arrhythmias per minute between groups. Gerbils rarely showed significant arrhythmias. Body weight and heart weight were not significantly different between groups, whereas liver weight increased with increasing iron dose in the treated group. Cardiac and hepatic iron concentrations were significantly increased in iron-loaded gerbils. Eight of 14 gerbils loaded to 6.2 g/kg body weight developed ascites. We conclude that an iron load sufficient to cause clinical liver disease does not cause cardiac arrhythmias in the gerbil model of iron overload.
已知与遗传性血色素沉着症或反复红细胞输血相关的慢性铁过载会导致心力衰竭。铁过载患者偶尔会出现心律失常,但这些心律失常常被认为与合并症有关。对麻醉的铁负荷沙鼠进行的短期记录研究表明,铁在心律失常的发生中起作用。我们的目标是在长期植入仪器、不受束缚且可遥测的沙鼠中表征铁诱导的心律失常。在铁负荷沙鼠(n = 23)和对照沙鼠(n = 8)中,每30分钟记录10秒心电图,持续约6个月。两组所有沙鼠均显示出频繁窦性心律失常的证据。两组之间的心率、心电图参数或每分钟心律失常数量没有差异。沙鼠很少出现明显的心律失常。两组之间的体重和心脏重量没有显著差异,而治疗组中肝脏重量随着铁剂量的增加而增加。铁负荷沙鼠的心脏和肝脏铁浓度显著升高。14只体重达到6.2 g/kg的沙鼠中有8只出现腹水。我们得出结论,在铁过载沙鼠模型中,足以导致临床肝病的铁负荷不会引起心律失常。