Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia.
Department of Arrhythmias and Pacing, National Institute of Cardiovascular Diseases, Pod Krásnou Hôrkou 1, 83348 Bratislava, Slovakia.
Int J Mol Sci. 2022 Jan 26;23(3):1416. doi: 10.3390/ijms23031416.
The prevention of cardiac life-threatening ventricular fibrillation and stroke-provoking atrial fibrillation remains a serious global clinical issue, with ongoing need for novel approaches. Numerous experimental and clinical studies suggest that oxidative stress and inflammation are deleterious to cardiovascular health, and can increase heart susceptibility to arrhythmias. It is quite interesting, however, that various cardio-protective compounds with antiarrhythmic properties are potent anti-oxidative and anti-inflammatory agents. These most likely target the pro-arrhythmia primary mechanisms. This review and literature-based analysis presents a realistic view of antiarrhythmic efficacy and the molecular mechanisms of current pharmaceuticals in clinical use. These include the sodium-glucose cotransporter-2 inhibitors used in diabetes treatment, statins in dyslipidemia and naturally protective omega-3 fatty acids. This approach supports the hypothesis that prevention or attenuation of oxidative and inflammatory stress can abolish pro-arrhythmic factors and the development of an arrhythmia substrate. This could prove a powerful tool of reducing cardiac arrhythmia burden.
预防危及生命的室性心律失常和引起中风的心房颤动仍然是一个严重的全球性临床问题，需要不断探索新的方法。大量的实验和临床研究表明，氧化应激和炎症对心血管健康有害，并会增加心脏发生心律失常的易感性。然而，有趣的是，具有抗心律失常特性的各种心脏保护化合物是有效的抗氧化和抗炎药物。这些药物可能主要针对心律失常的主要机制。本综述和基于文献的分析对当前临床应用的药物的抗心律失常疗效和分子机制进行了现实的评估。其中包括用于治疗糖尿病的钠-葡萄糖协同转运蛋白 2 抑制剂、用于治疗血脂异常的他汀类药物和天然保护性的 ω-3 脂肪酸。这种方法支持了这样一种假设，即预防或减轻氧化应激和炎症应激可以消除致心律失常因素和心律失常基质的发展。这可能是减少心脏心律失常负担的有力工具。
