Ito电流在冠心病多形性室速发生中的作用及奎尼丁的预防机制

The role of transient outward potassium current in the arrhythmogenesis of polymorphic ventricular tachycardia in patients with coronary artery disease and the prophylactic mechanism of quinidine

短联律间期室早引发的多形性室性心动过速(PVT)是冠心病(CAD)患者常见的危及生命的心律失常之一,血运重建和传统的抗心律失常药物无法有效预防这种恶性心律失常。最近的研究表明,2相折返可能是心肌缺血相关PVT的潜在机制,这与Brugada综合征和特发性心室颤动的发生机制相类似。瞬时外向钾电流(Ito)在2相折返的形成中起重要作用,奎尼丁已被证实可抑制Ito并预防CAD患者PVT的发生。

Polymorphic ventricular tachycardia(PVT)triggered by short-coupled premature ventricular complex is a common life-threatening arrhythmia in coronary artery disease(CAD),revascularization and traditional anti-arrhythmic drugs could not effectively prevent this malignant arrhythmia.Recent study suggested that phase 2 reentry could be the underlying mechanism of myocardial ischemia-related PVT,which was similar to that of Brugada syndrome and idiopathic ventricular fibrillation.Transient outward potassium current(Ito)plays an important role in the development of phase 2 reentry,and quinidine has been proved to inhibit Ito and prevent the occurrence of PVT in patients with CAD.