Siri-Angkul Natthaphat, Xie Lai-Hua, Chattipakorn Siriporn C, Chattipakorn Nipon
Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.
Front Physiol. 2018 Nov 15;9:1615. doi: 10.3389/fphys.2018.01615. eCollection 2018.
Iron, the most abundant transition metal element in the human body, plays an essential role in many physiological processes. However, without a physiologically active excretory pathway, iron is subject to strict homeostatic processes acting upon its absorption, storage, mobilization, and utilization. These intricate controls are perturbed in primary and secondary hemochromatoses, leading to a deposition of excess iron in multiple vital organs including the heart. Iron overload cardiomyopathy is the leading cause of mortality in patients with iron overload conditions. Apart from mechanical deterioration of the siderotic myocardium, arrhythmias reportedly contribute to a substantial portion of cardiac death associated with iron overload. Despite this significant impact, the cellular mechanisms of electrical disturbances in an iron-overloaded heart are still incompletely characterized. This review article focuses on cellular electrophysiological studies that directly investigate the effects of iron overload on the function of cardiac ion channels, including trans-sarcolemmal and sarcoplasmic reticulum Ca fluxes, as well as cardiac action potential morphology. Our ultimate aim is to provide a comprehensive summary of the currently available information that will encourage and facilitate further mechanistic elucidation of iron-induced pathoelectrophysiological changes in the heart.
铁是人体中含量最丰富的过渡金属元素,在许多生理过程中发挥着重要作用。然而,由于缺乏生理活性排泄途径,铁受到严格的稳态过程调控,这些过程作用于铁的吸收、储存、动员和利用。这些复杂的调控在原发性和继发性血色素沉着症中受到干扰,导致过量铁在包括心脏在内的多个重要器官中沉积。铁过载心肌病是铁过载患者死亡的主要原因。除了铁沉着性心肌的机械性退变外,据报道心律失常在与铁过载相关的心脏死亡中占很大比例。尽管有如此重大的影响,但铁过载心脏中电紊乱的细胞机制仍未完全明确。这篇综述文章聚焦于细胞电生理研究,这些研究直接探究铁过载对心脏离子通道功能的影响,包括跨肌膜和肌浆网钙通量,以及心脏动作电位形态。我们的最终目标是对当前可用信息进行全面总结,以鼓励并促进对铁诱导的心脏病理电生理变化进行进一步的机制阐释。