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Zhao Z, Zang X, Niu K, Song W, Wang X, Mügge A, Aweimer A, Hamdani N, Zhou X, Zhao Y, Akin I, El-Battrawy I. Impacts of gene variants on drug effects-the foundation of genotype-guided pharmacologic therapy for long QT syndrome and short QT syndrome. EBioMedicine 2024; 103:105108. [PMID: 38653189 PMCID: PMC11041837 DOI: 10.1016/j.ebiom.2024.105108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024] Open
Abstract
The clinical significance of optimal pharmacotherapy for inherited arrhythmias such as short QT syndrome (SQTS) and long QT syndrome (LQTS) has been increasingly recognised. The advancement of gene technology has opened up new possibilities for identifying genetic variations and investigating the pathophysiological roles and mechanisms of genetic arrhythmias. Numerous variants in various genes have been proven to be causative in genetic arrhythmias. Studies have demonstrated that the effectiveness of certain drugs is specific to the patient or genotype, indicating the important role of gene-variants in drug response. This review aims to summarize the reported data on the impact of different gene-variants on drug response in SQTS and LQTS, as well as discuss the potential mechanisms by which gene-variants alter drug response. These findings may provide valuable information for future studies on the influence of gene variants on drug efficacy and the development of genotype-guided or precision treatment for these diseases.
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Affiliation(s)
- Zhihan Zhao
- Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Xiaobiao Zang
- Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Kerun Niu
- Department of Orthopaedic, Henan Provincial People's Hospital; Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Weifeng Song
- Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Xianqing Wang
- Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Andreas Mügge
- Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr University of Bochum, 44789, Bochum, Germany
| | - Assem Aweimer
- Institute of Physiology, Department of Cellular and Translational Physiology, Medical Faculty and Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany
| | - Nazha Hamdani
- Institute of Physiology, Department of Cellular and Translational Physiology, Medical Faculty and Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany
- HCEMM-Cardiovascular Research Group, Department of Pharmacology and Pharmacotherapy, University of Budapest, Budapest, Hungary
- Department of Physiology, Cardiovascular Research Institute Maastricht University Maastricht, Maastricht, the Netherlands
| | - Xiaobo Zhou
- Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Medical Centre Mannheim, Heidelberg University, Germany
- Key Laboratory of Medical Electrophysiology of Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, China
| | - Yonghui Zhao
- Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Ibrahim Akin
- Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Medical Centre Mannheim, Heidelberg University, Germany
| | - Ibrahim El-Battrawy
- Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr University of Bochum, 44789, Bochum, Germany
- Institute of Physiology, Department of Cellular and Translational Physiology, Medical Faculty and Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany
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Piccioni A, Covino M, Zanza C, Longhitano Y, Tullo G, Bonadia N, Rinninella E, Ojetti V, Gasbarrini A, Franceschi F. Energy drinks: a narrative review of their physiological and pathological effects. Intern Med J 2021; 51:636-646. [PMID: 32369250 DOI: 10.1111/imj.14881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/18/2020] [Accepted: 03/29/2020] [Indexed: 12/19/2022]
Abstract
The consumption of energy drinks (Edks) has increased significantly in past years, with a growing market that is estimated to reach $61 billion by 2021 worldwide. Several studies demonstrated the physiological and pathological effects of these substances contained in Edks. The most common ingredient contained in Edks is caffeine, which is commonly mixed with taurine, and B-group vitamins. Scientific evidence of potentially serious adverse health effects are known, but it would be better to acquire more information regarding these beverages. We systematically checked Medical literature on MEDLINE-Pubmed from inception to January 2020 to find studies and reports on Edks and adverse events. Edks consumption is specially related to cardiovascular effects as malignant arrhythmias. We found a significant focus on arrhythmogenic risk in patients affected by long QT syndrome or other predisposing conditions for QT elongation. Other pathological effects are known as gastrointestinal, vascular and neurological disorders. Edks, as well as all caffeinated beverages, should be taken with caution or avoided in select populations, such as patients suffering from cardiovascular or neurological illnesses; their use can unmask a sleepy life-threatening disease.
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Affiliation(s)
- Andrea Piccioni
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marcello Covino
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Christian Zanza
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Anesthesia and Critical Care, Keck Medical School of University Southern California, California, Los Angeles, USA
| | - Yaroslava Longhitano
- Department of Anesthesia and Critical Care, Keck Medical School of University Southern California, California, Los Angeles, USA
| | - Gianluca Tullo
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Bonadia
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Rinninella
- UOC Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Veronica Ojetti
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- UOC Nutrizione Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Franceschi
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Shah SA, Szeto AH, Farewell R, Shek A, Fan D, Quach KN, Bhattacharyya M, Elmiari J, Chan W, O'Dell K, Nguyen N, McGaughey TJ, Nasir JM, Kaul S. Impact of High Volume Energy Drink Consumption on Electrocardiographic and Blood Pressure Parameters: A Randomized Trial. J Am Heart Assoc 2019; 8:e011318. [PMID: 31137991 PMCID: PMC6585360 DOI: 10.1161/jaha.118.011318] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Energy drinks have been linked to an increase in emergency room visits and deaths. We aim to determine the impact of energy drinks on electrocardiographic and hemodynamic parameters in young healthy volunteers. Methods and Results A randomized, double-masked, placebo-controlled, crossover study was conducted in healthy volunteers. Participants consumed 32 oz of either energy drink A, energy drink B, or placebo within 60 minutes on 3 study days with a 6-day washout period in between. The primary end point of QT c interval and secondary end points of QT interval, PR interval, QRS duration, heart rate, and brachial and central blood pressures were measured at baseline, and every 30 minutes for 240 minutes. A repeated-measures 2-way analysis of variance was performed with the main effects of intervention, time, and an interaction of intervention and time. Thirty-four participants were included (age 22.1±3.0 years). The interaction term of intervention and time was statistically significant for Bazett's corrected QT interval, Fridericia's corrected QT interval, QT , PR , QRS duration, heart rate, systolic blood pressure, diastolic blood pressure, central systolic blood pressure, and central diastolic blood pressure (all P<0.001). The maximum change from baseline in Bazett's corrected QT interval for drinks A, B, and placebo were +17.9±13.9, +19.6±15.8, and +11.9±11.1 ms, respectively ( P=0.005 for ANOVA ) ( P=0.04 and <0.01, respectively compared with placebo). Peripheral and central systolic and diastolic blood pressure were statistically significantly different compared with placebo (all P<0.001). Conclusion Energy drinks significantly prolong the QT c interval and raise blood pressure. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT03196908.
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Affiliation(s)
- Sachin A Shah
- 1 Department of Pharmacy Practice Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Andy H Szeto
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Raechel Farewell
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Allen Shek
- 1 Department of Pharmacy Practice Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Dorothy Fan
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Kathy N Quach
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Mouchumi Bhattacharyya
- 3 Department of Mathematics College of the Pacific University of the Pacific Stockton CA
| | - Jasmine Elmiari
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Winny Chan
- 2 Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Kate O'Dell
- 1 Department of Pharmacy Practice Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Nancy Nguyen
- 1 Department of Pharmacy Practice Thomas J Long School of Pharmacy and Health Sciences University of the Pacific Stockton CA
| | - Tracey J McGaughey
- 4 Department of Pharmacy David Grant USAF Medical Center Travis Air Force Base CA
| | - Javed M Nasir
- 5 Department of Electrophysiology Heart, Lung & Vascular Center David Grant USAF Medical Center Travis Air Force Base CA
| | - Sanjay Kaul
- 6 Division of Cardiology Cedars-Sinai Medical Center Los Angeles CA.,7 David Geffen School of Medicine at UCLA Los Angeles CA
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