缝隙连接增强剂联合 Vaughan Williams Ⅲ类抗心律失常药物，一种有前途的抗心律失常方法？

Gap junctions enhancer combined with Vaughan Williams class III antiarrhythmic drugs, a promising antiarrhythmic method?

机构信息

Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China.

出版信息

Med Hypotheses. 2011 Jan;76(1):119-21. doi: 10.1016/j.mehy.2010.08.047.

DOI:10.1016/j.mehy.2010.08.047

PMID:20889260

Abstract

Arrhythmias is one of the leading causes of death in the world. Current antiarrhythmic drugs are limited by unsatisfactory efficacy and adverse effects such as proarrhythmias. Reentry mechanism plays an important role in persistence of arrhythmias. Reentry can only continue when reentry path-length is longer than cardiac wavelength which is equal to the product of conduction velocity (CV) and effective refractory period (ERP). Gap junctions uncoupling is associated with proarrhythmic CV slowing and transmural dispersion of repolarization (TDR) increasing in many cardiac diseases. Vaughan Williams class III antiarrhythmic drugs prolong ERP with an augmented TDR which is the main mechanism of the proarrhythmic effects. Gap junctions enhancer can augment CV and diminish TDR. As a result, gap junctions enhancer combined with class III drugs may be a promising antiarrhythmic method.

摘要

心律失常是世界范围内主要的致死原因之一。目前的抗心律失常药物疗效不理想，并且有致心律失常等不良反应。折返机制在心律失常的持续存在中起着重要作用。只有当折返路径长度大于心脏波长时，折返才能继续，心脏波长等于传导速度（CV）和有效不应期（ERP）的乘积。在许多心脏疾病中，缝隙连接解偶联与致心律失常性 CV 减慢和复极离散度（TDR）增加有关。Vaughan Williams 类 III 抗心律失常药物通过增加 TDR 来延长 ERP，这是致心律失常作用的主要机制。缝隙连接增强剂可以增加 CV 并减少 TDR。因此，缝隙连接增强剂与 III 类药物联合使用可能是一种有前途的抗心律失常方法。