Wołowiec Łukasz, Grześk Grzegorz, Osiak Joanna, Wijata Aleksandra, Mędlewska Martyna, Gaborek Patryk, Banach Joanna, Wołowiec Anna, Głowacka Mariola
Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.
Department of Geriatrics, Division of Biochemistry and Biogerontology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.
Front Pharmacol. 2023 Jan 9;13:1043714. doi: 10.3389/fphar.2022.1043714. eCollection 2022.
β-blockers is a vast group of antiarrhythmic drugs which differ in their pharmacokinetic and chemical properties. Some of them block β-adrenergic receptors selectively while the others work non-selectively. Consequently, they reduce the influence of the sympathetic nervous system on the heart, acting negatively inotropic, chronotropic, bathmotropic and dromotropic. Although they have been present in medicine since the beginning of the 1960s, they still play a crucial role in the treatment of cardiac arrhythmias. They are also first-line group of drugs used to control the ventricular rate in patients with the most common arrhythmia-atrial fibrillation. Previous reports indicate that infection with SARS-CoV-2 virus may constitute an additional risk factor for arrhythmia. Due to the aging of the population in developed countries and the increase in the number of patients with cardiac burden, the number of people suffering from cardiac arrhythmias will increase in the upcoming years. As a result the role of above-mentioned beta-blockers will remain significant. Particularly noteworthy is propranolol-the oldest beta adrenergic antagonist, which in recent years has found additional applications due to its unique properties. In this article, we reviewed the accessible literature and summarized the current guidelines on the use of beta-blockers in the treatment of cardiac arrhythmias.
β受体阻滞剂是一大类抗心律失常药物,它们的药代动力学和化学性质各不相同。其中一些药物选择性地阻断β肾上腺素能受体,而另一些则非选择性地起作用。因此,它们降低了交感神经系统对心脏的影响,表现出负性肌力、负性变时、负性变传导和负性变传导速度作用。尽管自20世纪60年代初以来它们就已应用于医学,但它们在心律失常的治疗中仍发挥着关键作用。它们也是用于控制最常见心律失常——心房颤动患者心室率的一线药物。先前的报告表明,感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)可能是心律失常的一个额外危险因素。由于发达国家人口老龄化以及心脏负担患者数量增加,未来几年心律失常患者的数量将会增加。因此,上述β受体阻滞剂的作用仍将十分重要。特别值得注意的是普萘洛尔——最古老的β肾上腺素能拮抗剂,近年来因其独特的性质而有了新的应用。在本文中,我们回顾了可获取的文献,并总结了目前关于使用β受体阻滞剂治疗心律失常的指南。