Article

Phenotypic manifestations of mutations in genes encoding subunits of cardiac potassium channels.

Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.
Circulation Research (impact factor: 9.49). 06/2011; 109(1):97-109. DOI:10.1161/CIRCRESAHA.110.224600 pp.97-109
Source: PubMed

ABSTRACT Since 1995, when a potassium channel gene, hERG (human ether-à-go-go-related gene), now referred to as KCNH2, encoding the rapid component of cardiac delayed rectifier potassium channels was identified as being responsible for type 2 congenital long-QT syndrome, a number of potassium channel genes have been shown to cause different types of inherited cardiac arrhythmia syndromes. These include congenital long-QT syndrome, short-QT syndrome, Brugada syndrome, early repolarization syndrome, and familial atrial fibrillation. Genotype-phenotype correlations have been investigated in some inherited arrhythmia syndromes, and as a result, gene-specific risk stratification and gene-specific therapy and management have become available, particularly for patients with congenital long-QT syndrome. In this review article, the molecular structure and function of potassium channels, the clinical phenotype due to potassium channel gene mutations, including genotype-phenotype correlations, and the diverse mechanisms underlying the potassium channel gene-related diseases will be discussed.

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    Article: Clinical use of antidepressant therapy and associated cardiovascular risk.
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    ABSTRACT: A number of different psychotropic agents have been associated with an increased risk of cardiovascular disease, and these relationships have been difficult to interpret due to the presence of confounding factors. Recently, there has been renewed interest in the potential for certain antidepressants to cause QT prolongation, which is a predisposing factor for arrhythmia. However, the optimum means of determining QT remains contentious due to discrepancies between methods that may be readily applied in a clinical setting versus more detailed techniques during regulatory assessment. A number of different pharmacological mechanisms might explain the occurrence of adverse cardiac effects, and these differ according to the type of antidepressant agent. Emerging data indicate that citalopram exhibits a dose-effect relationship for QT prolongation. Whereas cardiotoxicity is readily apparent in the context of intentional antidepressant overdose, the occurrence of cardiac effects as a result of therapeutic administration is less certain. Pre-existing cardiac disease and other factors that independently predispose to arrhythmia are important considerations. Therefore, clinical judgment is needed to evaluate the overall risk or benefit of a particular antidepressant in any patient. Close monitoring should be considered for those at greatest risk of QT prolongation and arrhythmia.
    Drug, Healthcare and Patient Safety 01/2012; 4:93-101.

Keywords

cardiac arrhythmia syndromes
 
cause different types
 
clinical phenotype
 
congenital long-QT syndrome
 
diverse mechanisms
 
familial atrial fibrillation
 
gene-specific risk stratification
 
gene-specific therapy
 
Genotype-phenotype correlations
 
include congenital long-QT syndrome
 
inherited arrhythmia syndromes
 
molecular structure
 
potassium channel gene
 
potassium channel gene mutations
 
potassium channel gene-related diseases
 
potassium channel genes
 
potassium channels
 
rectifier potassium channels
 
review article
 
type 2 congenital long-QT syndrome