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Esaki H, Izumi S, Nishikawa K, Nagayasu K, Kaneko S, Nishitani N, Deyama S, Kaneda K. Role of medial prefrontal cortex voltage-dependent potassium 4.3 channels in nicotine-induced enhancement of object recognition memory in male mice. Eur J Pharmacol 2024; 978:176790. [PMID: 38942263 DOI: 10.1016/j.ejphar.2024.176790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/26/2024] [Indexed: 06/30/2024]
Abstract
Nicotine has been shown to enhance object recognition memory in the novel object recognition (NOR) test by activating excitatory neurons in the medial prefrontal cortex (mPFC). However, the exact neuronal mechanisms underlying the nicotine-induced activation of mPFC neurons and the resultant memory enhancement remain poorly understood. To address this issue, we performed brain-slice electrophysiology and the NOR test in male C57BL/6J mice. Whole-cell patch-clamp recordings from layer V pyramidal neurons in the mPFC revealed that nicotine augments the summation of evoked excitatory postsynaptic potentials (eEPSPs) and that this effect was suppressed by N-[3,5-Bis(trifluoromethyl)phenyl]-N'-[2,4-dibromo-6-(2H-tetrazol-5-yl)phenyl]urea (NS5806), a voltage-dependent potassium (Kv) 4.3 channel activator. In line with these findings, intra-mPFC infusion of NS5806 suppressed systemically administered nicotine-induced memory enhancement in the NOR test. Additionally, miRNA-mediated knockdown of Kv4.3 channels in mPFC pyramidal neurons enhanced object recognition memory. Furthermore, inhibition of A-type Kv channels by intra-mPFC infusion of 4-aminopyridine was found to enhance object recognition memory, while this effect was abrogated by prior intra-mPFC NS5806 infusion. These results suggest that nicotine augments the summation of eEPSPs via the inhibition of Kv4.3 channels in mPFC layer V pyramidal neurons, resulting in the enhancement of object recognition memory.
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Affiliation(s)
- Hirohito Esaki
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Shoma Izumi
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Keisuke Nishikawa
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Kazuki Nagayasu
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida-Shimoadachi-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Shuji Kaneko
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida-Shimoadachi-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Naoya Nishitani
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Satoshi Deyama
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Katsuyuki Kaneda
- Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, 920-1192, Japan.
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Teraoka JT, Tang JJ, Delling FN, Vittinghoff E, Marcus GM. Smoking Cessation and Incident Atrial Fibrillation in a Longitudinal Cohort. JACC Clin Electrophysiol 2024:S2405-500X(24)00635-2. [PMID: 39269397 DOI: 10.1016/j.jacep.2024.06.019] [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: 03/15/2024] [Revised: 05/28/2024] [Accepted: 06/17/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Although smoking heightens the risk of AF, it remains unknown if that risk is amenable to modification after smoking cessation. OBJECTIVES This study sought to evaluate the association between smoking cessation and atrial fibrillation (AF) risk in a large longitudinal cohort. METHODS After excluding those with prevalent AF and no history of smoking at baseline, we evaluated 146,772 UK Biobank participants with serial smoking assessments. We compared AF risk between former smokers at baseline and those who quit smoking during the study to current smokers. Incident AF was ascertained from outpatient and inpatient encounters and identified using International Classification of Diseases codes. Cox models were used to compare the risk of incident AF among current and former smokers as well as those who quit smoking during the study while controlling for age, sex, race, body mass index, education, cardiovascular comorbidities, alcohol use, and pack-years. RESULTS Among the 146,772 participants (48.3% female; age: 57.3 ± 7.9 years), 37,377 (25.5%) currently smoked; 105,429 (72.0%) were former smokers; and 3,966 (2.7%) quit smoking during the study. Over a mean 12.7 ± 2.0 years of follow-up, 11,214 (7.6%) participants developed AF. Compared to current smokers, the adjusted risk of AF was 13% lower in former smokers (HR: 0.87; 95% CI: 0.83-0.91) and 18% lower in those who quit smoking during the study (HR: 0.82; 95% CI: 0.70-0.95). CONCLUSIONS Compared to those who continue to smoke, smoking cessation was associated with a lower risk of AF.
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Affiliation(s)
- Justin T Teraoka
- Department of Medicine, Division of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Janet J Tang
- Department of Medicine, Division of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Francesca N Delling
- Department of Medicine, Division of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
| | - Gregory M Marcus
- Department of Medicine, Division of Cardiology, University of California-San Francisco, San Francisco, California, USA.
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Khan Minhas AM, Sedhom R, Jean ED, Shapiro MD, Panza JA, Alam M, Virani SS, Ballantyne CM, Abramov D. Global burden of cardiovascular disease attributable to smoking, 1990-2019: an analysis of the 2019 Global Burden of Disease Study. Eur J Prev Cardiol 2024; 31:1123-1131. [PMID: 38589018 DOI: 10.1093/eurjpc/zwae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 04/10/2024]
Abstract
AIMS This study aims to investigate the trends in the global cardiovascular disease (CVD) burden attributable to smoking from 1990 to 2019. METHODS AND RESULTS Global Burden of Disease Study 2019 was used to analyse the burden of CVD attributable to smoking (i.e. ischaemic heart disease, peripheral artery disease, stroke, atrial fibrillation and flutter, and aortic aneurysm). Age-standardized mortality rates (ASMRs) per 100 000 and age-standardized disability-adjusted life year rates (ASDRs) per 100 000, as well as an estimated annual percentage change (EAPC) in ASMR and ASDR, were determined by age, sex, year, socio-demographic index (SDI), regions, and countries or territories. The global ASMR of smoking-attributed CVD decreased from 57.16/100 000 [95% uncertainty interval (UI) 54.46-59.97] in 1990 to 33.03/100 000 (95% UI 30.43-35.51) in 2019 [EAPC -0.42 (95% UI -0.47 to -0.38)]. Similarly, the ASDR of smoking-attributed CVD decreased between 1990 and 2019. All CVD subcategories showed a decline in death burden between 1990 and 2019. The burden of smoking-attributed CVD was higher in men than in women. Significant geographic and regional variations existed such that Eastern Europe had the highest ASMR and Andean Latin America had the lowest ASMR in 2019. In 2019, the ASMR of smoking-attributed CVD was lowest in high SDI regions. CONCLUSION Smoking-attributed CVD morbidity and mortality are declining globally, but significant variation persists, indicating a need for targeted interventions to reduce smoking-related CVD burden.
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Affiliation(s)
| | - Ramy Sedhom
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, 2068 Orange Tree Lane, Suite 215, Redlands, CA 92374, USA
| | - Estelle D Jean
- Department of Cardiology, Medstar Heart and Vascular Institute, Silver Springs, MD, USA
| | - Michael D Shapiro
- Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julio A Panza
- Department of Cardiology, Westchester Medical Center, Valhalla, NY, USA
| | - Mahboob Alam
- Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Salim S Virani
- Aga Khan University, Karachi, Pakistan
- Baylor College of Medicine and Texas Heart Institute, Houston, TX, USA
| | | | - Dmitry Abramov
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, 2068 Orange Tree Lane, Suite 215, Redlands, CA 92374, USA
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Guevara A, Smith CER, Caldwell JL, Ngo L, Mott LR, Lee IJ, Tapa S, Wang Z, Wang L, Woodward WR, Ng GA, Habecker BA, Ripplinger CM. Chronic nicotine exposure is associated with electrophysiological and sympathetic remodeling in the intact rabbit heart. Am J Physiol Heart Circ Physiol 2024; 326:H1337-H1349. [PMID: 38551482 PMCID: PMC11381014 DOI: 10.1152/ajpheart.00749.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
Nicotine is the primary addictive component of tobacco products. Through its actions on the heart and autonomic nervous system, nicotine exposure is associated with electrophysiological changes and increased arrhythmia susceptibility. To assess the underlying mechanisms, we treated rabbits with transdermal nicotine (NIC, 21 mg/day) or control (CT) patches for 28 days before performing dual optical mapping of transmembrane potential (RH237) and intracellular Ca2+ (Rhod-2 AM) in isolated hearts with intact sympathetic innervation. Sympathetic nerve stimulation (SNS) was performed at the first to third thoracic vertebrae, and β-adrenergic responsiveness was additionally evaluated following norepinephrine (NE) perfusion. Baseline ex vivo heart rate (HR) and SNS stimulation threshold were higher in NIC versus CT (P = 0.004 and P = 0.003, respectively). Action potential duration alternans emerged at longer pacing cycle lengths (PCL) in NIC versus CT at baseline (P = 0.002) and during SNS (P = 0.0003), with similar results obtained for Ca2+ transient alternans. SNS shortened the PCL at which alternans emerged in CT but not in NIC hearts. NIC-exposed hearts tended to have slower and reduced HR responses to NE perfusion, but ventricular responses to NE were comparable between groups. Although fibrosis was unaltered, NIC hearts had lower sympathetic nerve density (P = 0.03) but no difference in NE content versus CT. These results suggest both sympathetic hypoinnervation of the myocardium and regional differences in β-adrenergic responsiveness with NIC. This autonomic remodeling may contribute to the increased risk of arrhythmias associated with nicotine exposure, which may be further exacerbated with long-term use.NEW & NOTEWORTHY Here, we show that chronic nicotine exposure was associated with increased heart rate, increased susceptibility to alternans, and reduced sympathetic electrophysiological responses in the intact rabbit heart. We suggest that this was due to sympathetic hypoinnervation of the myocardium and diminished β-adrenergic responsiveness of the sinoatrial node following nicotine treatment. Though these differences did not result in increased arrhythmia propensity in our study, we hypothesize that prolonged nicotine exposure may exacerbate this proarrhythmic remodeling.
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Affiliation(s)
- Amanda Guevara
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Charlotte E R Smith
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Jessica L Caldwell
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Lena Ngo
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Lilian R Mott
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - I-Ju Lee
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Srinivas Tapa
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - Zhen Wang
- Department of Pharmacology, University of California Davis, Davis, California, United States
- Shantou University Medical College, Shantou, People's Republic of China
| | - Lianguo Wang
- Department of Pharmacology, University of California Davis, Davis, California, United States
| | - William R Woodward
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, Oregon, United States
| | - G Andre Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health and Care Research, Leicester Biomedical Research Centre, Leicester, United Kingdom
- Glenfield Hospital, Leicester, United Kingdom
| | - Beth A Habecker
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, Oregon, United States
- Department of Medicine and Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, United States
| | - Crystal M Ripplinger
- Department of Pharmacology, University of California Davis, Davis, California, United States
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Baig MFA, Chaliki K. The impact of smoking on third-degree atrioventricular block outcomes: A propensity-matched analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 21:200289. [PMID: 38828463 PMCID: PMC11139760 DOI: 10.1016/j.ijcrp.2024.200289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/29/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024]
Abstract
Background Third-degree atrioventricular (AV) blocks are rare but cause significant symptoms and require immediate intervention. Coronary artery disease (CAD) is felt to be the most common etiology. Although smoking is a prominent risk factor for CAD, there is a paucity of data assessing the direct effect of smoking on third-degree AV block. Methods We performed a retrospective cohort study on adult-weighted admissions in 2019-2020 with a primary diagnosis of third-degree AV block and a history of smoking using the National Inpatient Sample (NIS) database. In-hospital mortality, rates of pacemaker insertion, cardiogenic shock, cardiac arrest, acute kidney injury (AKI), stroke, tracheal intubation, mechanical ventilation, mechanical circulatory support, vasopressor use, length of stay (LOS), and total hospitalization costs were analyzed using regression analysis. We performed a secondary analysis using propensity score matching to confirm the results. Results A total of 77,650 admissions met inclusion criteria (33,625 females [43.3 %], 58,315. Caucasians [75 %], 7030 African American [9 %], 6155 Hispanic [7.9 %]; mean [SD] age 75.4.[10.2] years) before propensity matching. A total of 29,380 (37.8 %) patients with AV block were smokers.A total of 5560 patients with and without a history of smoking were matched for the analysis. Smokers had.decreased odds of mortality (aOR, 0.59; CI, 0.44-0.78; p < 0.001), cardiogenic shock, cardiac arrest, tracheal intubation, mechanical ventilation, shorter LOS, and lower total hospital costs in both the multivariable regression and propensity-matched analyses. Conclusion Third-degree AV block had lower in-hospital mortality, cardiogenic shock, cardiac arrest, LOS, and total hospitalization cost in patients with smoking history.
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Affiliation(s)
- Mirza Faris Ali Baig
- Asante Three Rivers Medical Center, 500 SW Ramsey Avenue, Grants Pass, OR, USA, 97527
| | - Kalyan Chaliki
- University of Arizona. 1200 E University Blvd, Tucson, AZ, USA, 85721
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Leszto K, Frąk W, Kurciński S, Sinkowska J, Skwira S, Młynarska E, Rysz J, Franczyk B. Associations of Dietary and Lifestyle Components with Atrial Fibrillation. Nutrients 2024; 16:456. [PMID: 38337740 PMCID: PMC10856828 DOI: 10.3390/nu16030456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that still remains a significant health concern, especially due to its consequences, including stroke and heart failure. This review explores the intricate interplay between AF, lifestyle choices, and dietary habits. It is particularly focused on findings from diverse studies about non-pharmacological methods of managing AF. Moreover, its purpose is to elucidate the implementation of lifestyle changes such as physical activity or proper diet choices in the integrated treatment strategy of patients with AF.
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Affiliation(s)
- Klaudia Leszto
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Weronika Frąk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Szymon Kurciński
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Julia Sinkowska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
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Gonçalves MA, Pedro JM, Silva C, Magalhães P, Brito M. Influence of cigarette smoking on the Index of Cardiac Electrophysiological Balance in apparently healthy Angolans. Glob Cardiol Sci Pract 2024; 2024:e202405. [PMID: 38404660 PMCID: PMC10886906 DOI: 10.21542/gcsp.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/11/2023] [Indexed: 02/27/2024] Open
Abstract
Background: Tobacco use accelerates atherosclerosis and is one of the predictors of death from ischemic heart disease, arrhythmias, heart failure, and sudden death. A new non-invasive parameter, the Index of Cardiac Electrophysiological Balance (iCEB) between depolarization and repolarization of the action potential, was considered a new biomarker for the identification of patients at increased arrhythmic risk. Objectives: We aimed to evaluate the iCEB in apparently healthy Angolans with habitual cigarette smoking compared to non-smokers. Subjects and methods: Data were obtained from the CardioBengo study, a cross-sectional community-based study in which a random sample of individuals aged between 15 and 84 years was selected. In total, 214 apparently healthy subjects, 102 smokers, and 112 non-smokers in the same age group were included in the final analysis. Results: The average age of the participants was 42.17 ± 13.04 years old and 26.6% of the sample was female. Smoking subjects had higher iCEB and corrected Index of Cardiac Electrophysiological Balance (iCEBc) values compared with non-smoking controls (4.39 vs. 4.25; p = 0.024, respectively), and (4.74 vs. 4.57; p = 0.030, respectively). Conclusions: In summary, iCEB and iCEBc were significantly higher in habitual smokers than in nonsmokers, which represents an increased risk of ventricular arrhythmogenesis in healthy habitual smokers. To the best of our knowledge, this is the first study performed in Africa to evaluate iCEB in smokers, making this type of study very important in low- and middle-income countries in the context of epidemiological transition.
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Affiliation(s)
- Mauer A.A. Gonçalves
- Centro de Estudos Avançados em Educação e Formação Médica (CEDUMED), Faculty of Medicine, Agostinho Neto University, Luanda, Angola
- Department of Physiological Sciences, Faculty of Medicine, Agostinho Neto University, Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Angola
| | | | - Carina Silva
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
- CEAUL - Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - Pedro Magalhães
- Department of Physiological Sciences, Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Miguel Brito
- Centro de Investigação em Saúde de Angola (CISA), Angola
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
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Irfan A, Riggs DW, Koromia G, DeFilippis AP, Soliman EZ, Bhatnagar A, Carll AP. Smoking-associated Electrocardiographic Abnormalities Predict Cardiovascular Mortality: Insights from NHANES. RESEARCH SQUARE 2024:rs.3.rs-3615687. [PMID: 38260619 PMCID: PMC10802705 DOI: 10.21203/rs.3.rs-3615687/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background— Smoking is associated with arrhythmia and sudden cardiac death, but the biological mechanisms remain unclear. Abnormal electrocardiogram (ECG) durations of ventricular repolarization (QT interval), atrial depolarization (P wave), and atrioventricular depolarization (PR interval and segment), predict cardiac arrhythmia and mortality. Objectives— To elucidate how smoking affects cardiac excitation, we assessed in a nationally representative sample (NHANES III) associations between cotinine, abnormalities in P duration, PR interval, PR segment, rate-corrected QT (QTc), QRS duration, and JT interval, and long-term mortality. Methods— We analyzed data from 5,633 adults using survey-weighted multinomial logistic regression to estimate associations between tobacco use (>15 ng/ml serum cotinine) and short (<5th percentile) or long (>95th percentile) ECG intervals, relative to reference (5 - 95th percentile). Results— After adjustment for demographics, risk factors, and conduction-altering medications, smoking was associated with a higher odds of short PR interval, PR segment, and QRS, and long JT. Broader ECG effects of smoking were also assessed by survey-weighted linear regression of continuous cotinine and ECG intervals, which revealed cotinine inversely associated with PR segment and QTc. Over a 22-year follow-up, many ECG abnormalities predicted cardiovascular mortality in smokers, including long JT, QRS, and QTc, and short QRS. Conclusions— Smoking increases likelihood for rapid atrioventricular conduction, rapid ventricular depolarization, and slow ventricular repolarization. The ventricular electrophysiologic abnormalities associated with smoking also predict cardiovascular mortality in smokers; however, traditional ECG measures of cardiac risk like QTc can overlook these ventricular defects and their independent predictive value in smokers.
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Tungar IM, Rama Krishna Reddy MM, Flores SM, Pokhrel P, Ibrahim AD. The Influence of Lifestyle Factors on the Occurrence and Severity of Premature Ventricular Contractions: A Comprehensive Review. Curr Probl Cardiol 2024; 49:102072. [PMID: 37689374 DOI: 10.1016/j.cpcardiol.2023.102072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
Premature ventricular contractions (PVC) are a type of ventricular arrhythmias, occurring as a result of formation or reentry of an abnormal impulse in the ventricular myocardium or in the Purkinje system. PVC occurs commonly in healthy individuals and is observed in 1%-4% of the population. Several lifestyle factors like stress levels, caffeine, drugs, alcohol, nicotine, sleep, and physical exercise have been implicated in increasing the risk. Caffeine and drugs precipitate heightened cardiac stimulation, precipitating PVCs. Excessive alcohol and nicotine disturb the electrical pathways resulting in PVCs. Higher rates of PVCs have been associated with obesity. Individuals with insomnia and increased stress levels are also at an increased risk due to an imbalance in the autonomic system. Exercise is known to induce PVCs, including in healthy, asymptomatic individuals. Modification of these factors can decrease PVC risk. This article aims to provide a comprehensive review of the effects of lifestyle factors on PVC.
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Affiliation(s)
- Ishan M Tungar
- Department of Internal Medicine, B J Government Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
| | | | - Sofia M Flores
- Department of Psychiatry, University of Medicine and Health Sciences, Saint Kitts
| | - Prakriti Pokhrel
- Department of Psychiatry, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
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Mikagi M, Tashiro K, Komaki T, Shiga Y, Tachibana T, Higashi S, Kawahira Y, Suematsu Y, Ideishi A, Ogawa M, Miura SI. Association between paroxysmal or persistent atrial fibrillation and hyperuricemia in patients who underwent coronary computed tomography angiography: from the FU-CCTA-AF Registry. Heart Vessels 2023; 38:1451-1458. [PMID: 37592025 DOI: 10.1007/s00380-023-02299-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Hyperuricemia (HU) and hypertension (HTN) contribute to atherosclerotic cardiovascular disease, and both are also involved in the onset and development of atrial fibrillation (AF). OBJECTIVE In the present study, we investigated the association between risk factors for atherosclerosis [including HU, HTN, blood pressure and serum uric acid (UA) levels] and paroxysmal atrial fibrillation (Paro-AF) or persistent atrial fibrillation (Pers-AF) in patients who underwent coronary computed tomography angiography (CCTA). METHODS We enrolled 263 patients from the Fukuoka University-CCTA-AF (FU-CCTA-AF Registry) who underwent CCTA prior to AF ablation therapy. AF was classified as either Paro-AF (≤ 7 days) or Pers-AF (> 7 days). HU was diagnosed by a serum UA level > 7.0 mg/dl, and coronary artery disease (CAD) was diagnosed when CCTA results showed ≥ 50% significant coronary artery stenosis. The number of significantly diseased coronary artery vessels (VD), the Gensini score and the coronary artery calcification score (CACS) were measured. Left atrial morphology was also evaluated. RESULTS Diastolic blood pressure and HbA1c in the Pers-AF group were significantly higher than those in the Paro-AF group. The Pers-AF group showed a significantly higher prevalence of HU and higher UA levels than the Paro-AF group. In a multivariate logistic regression analysis, HU was an independent associated factor to Pers-AF (odds ratio: 2.023, 95% confidence interval: 1.055-3.881, p = 0.034), while HTN was not. CONCLUSION In patients with AF, HU is associated with Pers-AF.
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Affiliation(s)
- Masashi Mikagi
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Kohei Tashiro
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Tomo Komaki
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Yuhei Shiga
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| | - Tetsuro Tachibana
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Sara Higashi
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Yuto Kawahira
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Yasunori Suematsu
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Akihito Ideishi
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Masahiro Ogawa
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Laboratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan.
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan.
- Department of Laboratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
- Department of Internal Medicine, Fukuoka University Nishijin Hospital, Fukuoka, Japan.
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11
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Guevara A, Smith CER, Caldwell JL, Ngo L, Mott LR, Lee IJ, Tapa I, Wang Z, Wang L, Woodward WR, Ng GA, Habecker BA, Ripplinger CM. Chronic nicotine exposure is associated with electrophysiological and sympathetic remodeling in the intact rabbit heart. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.23.567754. [PMID: 38045290 PMCID: PMC10690259 DOI: 10.1101/2023.11.23.567754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Nicotine is the primary addictive component in tobacco products. Through its actions on the heart and autonomic nervous system, nicotine exposure is associated with electrophysiological changes and increased arrhythmia susceptibility. However, the underlying mechanisms are unclear. To address this, we treated rabbits with transdermal nicotine (NIC, 21 mg/day) or control (CT) patches for 28 days prior to performing dual optical mapping of transmembrane potential (RH237) and intracellular Ca 2+ (Rhod-2 AM) in isolated hearts with intact sympathetic innervation. Sympathetic nerve stimulation (SNS) was performed at the 1 st - 3 rd thoracic vertebrae, and β-adrenergic responsiveness was additionally evaluated as changes in heart rate (HR) following norepinephrine (NE) perfusion. Baseline ex vivo HR and SNS stimulation threshold were increased in NIC vs. CT ( P = 0.004 and P = 0.003 respectively). Action potential duration alternans emerged at longer pacing cycle lengths (PCL) in NIC vs. CT at baseline ( P = 0.002) and during SNS ( P = 0.0003), with similar results obtained for Ca 2+ transient alternans. SNS reduced the PCL at which alternans emerged in CT but not NIC hearts. NIC exposed hearts also tended to have slower and reduced HR responses to NE perfusion. While fibrosis was unaltered, NIC hearts had lower sympathetic nerve density ( P = 0.03) but no difference in NE content vs. CT. These results suggest both sympathetic hypo-innervation of the myocardium and diminished β-adrenergic responsiveness with NIC. This autonomic remodeling may underlie the increased risk of arrhythmias associated with nicotine exposure, which may be further exacerbated with continued long-term usage. NEW & NOTEWORTHY Here we show that chronic nicotine exposure was associated with increased heart rate, lower threshold for alternans and reduced sympathetic electrophysiological responses in the intact rabbit heart. We suggest that this was due to the sympathetic hypo-innervation of the myocardium and diminished β- adrenergic responsiveness observed following nicotine treatment. Though these differences did not result in increased arrhythmia propensity in our study, we hypothesize that prolonged nicotine exposure may exacerbate this pro-arrhythmic remodeling.
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12
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Jones CA, Wallace MJ, Bandaru P, Woodbury ED, Mohler PJ, Wold LE. E-cigarettes and arrhythmogenesis: a comprehensive review of pre-clinical studies and their clinical implications. Cardiovasc Res 2023; 119:2157-2164. [PMID: 37517059 PMCID: PMC10578912 DOI: 10.1093/cvr/cvad113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/21/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Electronic cigarette use has grown exponentially in recent years, and while their popularity has increased, the long-term effects on the heart are yet to be fully studied and understood. Originally designed as devices to assist with those trying to quit traditional combustible cigarette use, their popularity has attracted use by teens and adolescents who traditionally have not smoked combustible cigarettes. Acute effects on the heart have been shown to be similar to traditional combustible cigarettes, including increased heart rate and blood pressure. The main components of electronic cigarettes that contribute to these arrhythmic effects are found in the e-liquid that is aerosolized and inhaled, comprised of nicotine, flavourings, and a combination of vegetable glycerin (VG) and propylene glycol (PG). Nicotine can potentially induce both ventricular and atrial arrhythmogenesis, with both the atrial and ventricular effects resulting from the interactions of nicotine and the catecholamines they release via potassium channels. Atrial arrhythmogenesis, more specifically atrial fibrillation, can also occur due to structural alterations, which happens because of nicotine downregulating microRNAs 133 and 590, both post-transcriptional growth factor repressors. Liquid flavourings and the combination of PG and VG can possibly lead to arrhythmic events by exposing users to acrolein, an aldehyde that stimulates TRPA1 that in turn causes a change towards sympathetic activation and autonomic imbalance. The design of these electronic delivery devices is constantly changing; therefore, it has proven extremely difficult to study the long-term effects on the heart caused by electronic cigarettes but will be important to understand given their rising popularity. The arrhythmic effects of electronic cigarettes appear similar to traditional cigarettes as well; however, a comprehensive review has not been compiled and is the focus of this article.
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Affiliation(s)
- Carson A Jones
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Michael J Wallace
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Priya Bandaru
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Emerson D Woodbury
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Peter J Mohler
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
- Department of Internal Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Loren E Wold
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
- Division of Cardiac Surgery, Department of Surgery, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Room 603, Columbus, OH 43210, USA
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13
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Angarita GA, Pittman B, Nararajan A, Mayerson TF, Parate A, Marlin B, Gueorguieva RR, Potenza MN, Ganesan D, Malison RT. Discriminating cocaine use from other sympathomimetics using wearable electrocardiographic (ECG) sensors. Drug Alcohol Depend 2023; 250:110898. [PMID: 37523916 PMCID: PMC10905422 DOI: 10.1016/j.drugalcdep.2023.110898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/05/2023] [Accepted: 07/09/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Our group has established the feasibility of using on-body electrocardiographic (ECG) sensors to detect cocaine use in the human laboratory. The purpose of the current study was to test whether ECG sensors and features are capable of discriminating cocaine use from other non-cocaine sympathomimetics. METHODS Eleven subjects with cocaine use disorder wore the Zephyr BioHarness™ 3 chest band under six experimental (drug and non-drug) conditions, including 1) laboratory, intravenous cocaine self-administration, 2) after a single oral dose of methylphenidate, 3) during aerobic exercise, 4) during tobacco use (N=7 who smoked tobacco), and 5) during routine activities of daily inpatient living (unit activity). Three ECG-derived feature sets served as primary outcome measures, including 1) the RR interval (i.e., heart rate), 2) a group of ECG interval proxies (i.e., PR, QS, QT and QTc intervals), and 3) the full ECG waveform. Discriminatory power between cocaine and non-cocaine conditions for each of the three outcomes measures was expressed as the area under the receiver operating characteristics (AUROC) curve. RESULTS All three outcomes successfully discriminated cocaine use from unit activity, exercise, tobacco, and methylphenidate conditions with a mean AUROC values ranging from 0.66 to 0.99 and with least squares means values all statistically different/higher than 0.5 among all subjects [F(3, 99) = 3.38, p =0.02] and among those with tobacco use [F(4, 84) = 5.39, p = 0.0007]. CONCLUSIONS These preliminary results support discriminatory power of wearable ECG sensors for detecting cocaine use.
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Affiliation(s)
- Gustavo A Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA.
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Annamalai Nararajan
- Philips Research North America, Cambridge, MA02141, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Talia F Mayerson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Abhinav Parate
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Lumme Health Inc, Boston, MA02210, USA
| | - Benjamin Marlin
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Ralitza R Gueorguieva
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT06510, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT06510, USA; Department of Neuroscience, Yale University, New Haven, CT06510, USA; Connecticut Council on Problem Gambling, Wethersfield, CT06109, USA; Wu Tsai Institute, New Haven, CT06510, USA
| | - Deepak Ganesan
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Robert T Malison
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Department of Neuroscience, Yale University, New Haven, CT06510, USA
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14
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Becchetti A, Grandi LC, Cerina M, Amadeo A. Nicotinic acetylcholine receptors and epilepsy. Pharmacol Res 2023; 189:106698. [PMID: 36796465 DOI: 10.1016/j.phrs.2023.106698] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/04/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Despite recent advances in understanding the causes of epilepsy, especially the genetic, comprehending the biological mechanisms that lead to the epileptic phenotype remains difficult. A paradigmatic case is constituted by the epilepsies caused by altered neuronal nicotinic acetylcholine receptors (nAChRs), which exert complex physiological functions in mature as well as developing brain. The ascending cholinergic projections exert potent control of forebrain excitability, and wide evidence implicates nAChR dysregulation as both cause and effect of epileptiform activity. First, tonic-clonic seizures are triggered by administration of high doses of nicotinic agonists, whereas non-convulsive doses have kindling effects. Second, sleep-related epilepsy can be caused by mutations on genes encoding nAChR subunits widely expressed in the forebrain (CHRNA4, CHRNB2, CHRNA2). Third, in animal models of acquired epilepsy, complex time-dependent alterations in cholinergic innervation are observed following repeated seizures. Heteromeric nAChRs are central players in epileptogenesis. Evidence is wide for autosomal dominant sleep-related hypermotor epilepsy (ADSHE). Studies of ADSHE-linked nAChR subunits in expression systems suggest that the epileptogenic process is promoted by overactive receptors. Investigation in animal models of ADSHE indicates that expression of mutant nAChRs can lead to lifelong hyperexcitability by altering i) the function of GABAergic populations in the mature neocortex and thalamus, ii) synaptic architecture during synaptogenesis. Understanding the balance of the epileptogenic effects in adult and developing networks is essential to plan rational therapy at different ages. Combining this knowledge with a deeper understanding of the functional and pharmacological properties of individual mutations will advance precision and personalized medicine in nAChR-dependent epilepsy.
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Affiliation(s)
- Andrea Becchetti
- Department of Biotechnology and Biosciences, and NeuroMI (Milan Center of Neuroscience), University of Milano-Bicocca, Piazza della Scienza 2, Milano 20126, Italy.
| | - Laura Clara Grandi
- Department of Biotechnology and Biosciences, and NeuroMI (Milan Center of Neuroscience), University of Milano-Bicocca, Piazza della Scienza 2, Milano 20126, Italy.
| | - Marta Cerina
- Department of Biotechnology and Biosciences, and NeuroMI (Milan Center of Neuroscience), University of Milano-Bicocca, Piazza della Scienza 2, Milano 20126, Italy.
| | - Alida Amadeo
- Department of Biosciences, University of Milano, Via Celoria 26, Milano 20133, Italy.
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15
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Abstract
The global prevalence of atrial fibrillation (AF) has increased substantially over the past three decades and is currently approximately 60 million cases. Incident AF and its clinical consequences are largely the result of risk factors that can be modified by lifestyle changes. In this Review, we provide evidence that the lifetime risk of AF is modified not only by sex and race but also through the clinical risk factor and comorbidity burden of individual patients. We begin by summarizing the epidemiology of AF, focusing on non-modifiable and modifiable risk factors, as well as targets and strategies for the primary prevention of AF. Furthermore, we evaluate the role of modifiable risk factors in the secondary prevention of AF as well as the potential effects of risk factor interventions on the frequency and severity of subsequent AF episodes. We end the Review by proposing strategies that require evaluation as well as global policy changes that are needed for the prevention of incident AF and the management of recurrent episodes in patients already affected by AF.
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16
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E-cigarettes and their lone constituents induce cardiac arrhythmia and conduction defects in mice. Nat Commun 2022; 13:6088. [PMID: 36284091 PMCID: PMC9596490 DOI: 10.1038/s41467-022-33203-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 08/24/2022] [Indexed: 01/11/2023] Open
Abstract
E-cigarette use has surged, but the long-term health effects remain unknown. E-cigarette aerosols containing nicotine and acrolein, a combustion and e-cigarette byproduct, may impair cardiac electrophysiology through autonomic imbalance. Here we show in mouse electrocardiograms that acute inhalation of e-cigarette aerosols disturbs cardiac conduction, in part through parasympathetic modulation. We demonstrate that, similar to acrolein or combustible cigarette smoke, aerosols from e-cigarette solvents (vegetable glycerin and propylene glycol) induce bradycardia, bradyarrhythmias, and elevations in heart rate variability during inhalation exposure, with inverse post-exposure effects. These effects are slighter with tobacco- or menthol-flavored aerosols containing nicotine, and in female mice. Yet, menthol-flavored and PG aerosols also increase ventricular arrhythmias and augment early ventricular repolarization (J amplitude), while menthol uniquely alters atrial and atrioventricular conduction. Exposure to e-cigarette aerosols from vegetable glycerin and its byproduct, acrolein, diminish heart rate and early repolarization. The pro-arrhythmic effects of solvent aerosols on ventricular repolarization and heart rate variability depend partly on parasympathetic modulation, whereas ventricular arrhythmias positively associate with early repolarization dependent on the presence of nicotine. Our study indicates that chemical constituents of e-cigarettes could contribute to cardiac risk by provoking pro-arrhythmic changes and stimulating autonomic reflexes.
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17
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Ohlrogge AH, Frost L, Schnabel RB. Harmful Impact of Tobacco Smoking and Alcohol Consumption on the Atrial Myocardium. Cells 2022; 11:2576. [PMID: 36010652 PMCID: PMC9406618 DOI: 10.3390/cells11162576] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Tobacco smoking and alcohol consumption are widespread exposures that are legal and socially accepted in many societies. Both have been widely recognized as important risk factors for diseases in all vital organ systems including cardiovascular diseases, and with clinical manifestations that are associated with atrial dysfunction, so-called atrial cardiomyopathy, especially atrial fibrillation and stroke. The pathogenesis of atrial cardiomyopathy, atrial fibrillation, and stroke in context with smoking and alcohol consumption is complex and multifactorial, involving pathophysiological mechanisms, environmental, and societal aspects. This narrative review summarizes the current literature regarding alterations in the atrial myocardium that is associated with smoking and alcohol.
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Affiliation(s)
- Amelie H. Ohlrogge
- Department of Cardiology, University Heart and Vascular Centre Hamburg, 20246 Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Lars Frost
- Diagnostic Centre, University Clinic for Development of Innovative Patient Pathways, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Renate B. Schnabel
- Department of Cardiology, University Heart and Vascular Centre Hamburg, 20246 Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
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18
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Amialchuk A, Sapci O. The long-term health effects of initiating smoking in adolescence: Evidence from a national longitudinal survey. HEALTH ECONOMICS 2022; 31:597-613. [PMID: 34989036 DOI: 10.1002/hec.4469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 10/20/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
We estimate the long-term effect of initiating smoking in adolescence on a range of health outcomes later in life. We use the second wave (1996) and the fifth wave (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) and estimate instrumental variables models with school-level fixed effects, where the instruments are the average rate of smoking among friends and the respondents' perceptions about their friends' smoking. We find that smoking in adolescence has a negative impact on 15 of the 28 self-reported, diagnosed, and self-identified health outcomes approximately 20 years later.
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Affiliation(s)
| | - Onur Sapci
- Department of Economics, University of Toledo, Toledo, Ohio, USA
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19
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Fredgart MH, Lindholt JS, Brandes A, Steffensen FH, Frost L, Lambrechtsen J, Karon M, Busk M, Urbonaviciene G, Egstrup K, Khurrami L, Gerke O, Diederichsen ACP. Association of Left Atrial Size Measured by Non-Contrast Computed Tomography with Cardiovascular Risk Factors—The Danish Cardiovascular Screening Trial (DANCAVAS). Diagnostics (Basel) 2022; 12:diagnostics12020244. [PMID: 35204336 PMCID: PMC8871467 DOI: 10.3390/diagnostics12020244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/18/2022] [Indexed: 02/06/2023] Open
Abstract
Left atrium (LA) size is associated with adverse cardiovascular events. The purpose of this study was to investigate the association of LA enlargement measured by non-contrast CT (NCCT) with traditional cardiovascular risk factors. Individuals aged 60–75 years from the population-based multicentre Danish Cardiovascular Screening (DANCAVAS) trial were included in this cross-sectional study. The LA was manually traced on the NCCT scans, and the largest cross-section area was indexed to body surface area. All traditional risk factors were recorded, and a subgroup received an echocardiographic examination. We enrolled 14,987 individuals. Participants with known cardiovascular disease or lacking measurements of LA size or body surface area were excluded, resulting in 10,902 men for the main analysis and 616 women for a sensitivity analysis. Adjusted multivariable analysis showed a significantly increased indexed LA size by increasing age and pulse pressure, while smoking, HbA1c, and total cholesterol were associated with decreased indexed LA size. The findings were confirmed in a supplementary analysis including left ventricle ejection fraction and mass. In this population-based cohort of elderly men, an association was found between age and pulse pressure and increasing LA size. Surprisingly, smoking, HbA1c, and total cholesterol were associated with a decrease in LA size. This indicates that the pathophysiology behind atrial cardiomyopathy is not only reflected by enlargement, but also shrinking.
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Affiliation(s)
- Maise Høigaard Fredgart
- Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.F.); (A.B.); (L.K.)
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, 5000 Odense, Denmark
| | - Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, 5000 Odense, Denmark;
- Cardiovascular Centre of Excellence (CAVAC), Odense University Hospital, 5000 Odense, Denmark
- Elitary Research Centre of Individualised Medicine in Arterial Disease, Odense University Hospital, 5000 Odense, Denmark
| | - Axel Brandes
- Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.F.); (A.B.); (L.K.)
| | | | - Lars Frost
- Department of Cardiology, Regional Hospital Central Jutland, 8600 Silkeborg, Denmark; (L.F.); (G.U.)
| | - Jess Lambrechtsen
- Department of Cardiology, Svendborg Hospital, 5700 Svendborg, Denmark; (J.L.); (K.E.)
| | - Marek Karon
- Department of Medicine, Nykøbing Falster Hospital, 4800 Nykøbing Falster, Denmark;
| | - Martin Busk
- Department of Cardiology, Hospital Lillebælt, 7100 Vejle, Denmark; (F.H.S.); (M.B.)
| | - Grazina Urbonaviciene
- Department of Cardiology, Regional Hospital Central Jutland, 8600 Silkeborg, Denmark; (L.F.); (G.U.)
| | - Kenneth Egstrup
- Department of Cardiology, Svendborg Hospital, 5700 Svendborg, Denmark; (J.L.); (K.E.)
| | - Lida Khurrami
- Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.F.); (A.B.); (L.K.)
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
| | - Axel Cosmus Pyndt Diederichsen
- Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark; (M.H.F.); (A.B.); (L.K.)
- Elitary Research Centre of Individualised Medicine in Arterial Disease, Odense University Hospital, 5000 Odense, Denmark
- Correspondence:
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20
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Bendel GS, Hiller HM, Ralston A. Nicotine Toxicity Secondary to Aftermarket Modifications to a Vaping Device. Mil Med 2021; 187:e1007-e1010. [PMID: 34114039 DOI: 10.1093/milmed/usab223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Electronic cigarettes continue to rise in popularity as a reportedly safe alternative to standard cigarette smoking. Their use has become common in our society and specifically in our young active duty population. This cigarette smoking alternative has come under recent scrutiny with the discovery of e-cigarette or vaping product use-associated lung injury. However, there is another potential risk associated with vaping: the relative ease at which vaping devices can be modified has allowed a growing community of users to invent novel ways of delivering higher concentrations of nicotine. Here, we describe two cases of active duty patients who presented to an emergency department with clinical nicotine toxicity after using a heavily modified e-cigarette.
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Affiliation(s)
- Garrett S Bendel
- Carl R. Darnall Army Medical Center Emergency Medicine Residency Program, Fort Hood, TX 76544, USA
| | - Hugh M Hiller
- Carl R. Darnall Army Medical Center Emergency Medicine Residency Program, Fort Hood, TX 76544, USA
| | - Aaron Ralston
- Carl R. Darnall Army Medical Center Emergency Medicine Residency Program, Fort Hood, TX 76544, USA
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21
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Keskin G, Karaman ST, Basat O. Evaluation of the relationship between the level of addiction and exhaled carbon monoxide levels with QT dispersion in smokers. Tob Induc Dis 2021; 19:22. [PMID: 33815033 PMCID: PMC8010797 DOI: 10.18332/tid/133053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking increases the risk of arrhythmia. QT dispersion (QTd) is an important indicator for the determination of ventricular arrhythmia. In this study, we aimed to determine the arrhythmia risk by evaluating QTd in smokers and to assess the relationship between the level of nicotine addiction and carbon monoxide (CO) level in the expiratory air. METHODS This study was designed as a single-center, cross-sectional study. Among the chronic smokers referred to the Smoking Cessation Clinic of a tertiary hospital between October 2019 and January 2020, all those who had no risk factors for cardiac arrhythmias, except smoking, were included in the study. Sociodemographic data and smoking characteristics of the participants were collected and exhaled CO levels were measured. QT intervals were measured in all leads by using a 12-lead standard electrocardiogram (ECG), and heart rate corrected QT (QTc) intervals, QT dispersion (QTd), and corrected QT dispersion (QTcd) were calculated. RESULTS The mean age of the 250 patients was 37.2±9.3 years and the majority of patients (65%) were male. The mean amount of smoking was 25.74±16.03 packs/year and the mean value of CO was 12.36±7.06 ppm. The mean QTd was 23.83±13.12 ms, and the mean QTcd was 26.63±15.02 ms. A statistically significant relationship was found between QTd and QTcd and level of addiction, consumption of sticks/day and packs/year, and exhaled CO values (all p<0.001). CONCLUSIONS It was found that as the level of addiction, cigarette use amount, exhaled CO levels, and BMI increased in smokers, QT dispersion and arrhythmia risk increased.
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Affiliation(s)
- Gamze Keskin
- Gaziosmanpaşa Training and Research Hospital, Department of Family Medicine, University of Health Sciences, Istanbul, Turkey
| | - Sibel Tunç Karaman
- Gaziosmanpaşa Training and Research Hospital, Department of Family Medicine, University of Health Sciences, Istanbul, Turkey
| | - Okcan Basat
- Gaziosmanpaşa Training and Research Hospital, Department of Family Medicine, University of Health Sciences, Istanbul, Turkey
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22
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Yadav M, Kumari P, Yadav V, Kumar S. Pharmacological preconditioning with phosphodiestrase inhibitor: an answer to stem cell survival against ischemic injury through JAK/STAT signaling. Heart Fail Rev 2021; 25:355-366. [PMID: 31309353 DOI: 10.1007/s10741-019-09822-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Stem cell transplantation in regenerative medicine has been widely used in various disorders including cardiovascular diseases (CVD) and emerging next-generation therapy. However, transplanted stem cell encountered ischemia/reperfusion (IR) injury which is a major challenge for stem cell survival. During the acute phase after myocardial infarction (MI) cytokine-rich hostile microenvironment, extensive immune cell infiltration and lack of oxygen have been a bottleneck in cell-based therapy. During prolonged ischemia, intracellular pH and ATP level decrease results in anaerobic metabolism and lactate accumulation. Consequentially, ATPase-dependent ion transport becomes dysfunctional, contributing to calcium overload and cell death by apoptosis and necrosis. Although O2 level revitalizes upon reperfusion, a surge in the generation of reactive oxygen species (ROS) occurs with neutrophil infiltration in ischemic tissues further aggravating the injury. Ischemic preconditioning (IPC) of stem cells with a repeated short cycle of IR results in the release of chemical signals such as NO, ROS, and adenosine which triggers a cascade of signaling events that activates protein kinase C (PKC), Src protein tyrosine kinases, and nuclear factor κB (NF-κB) and subsequently increased synthesis of inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), Heme oxygenase-1 [HO-1], aldose reductase, Mn superoxide dismutase, and anti-apoptotic genes (Mcl-1, BCl-xL, c-FLIPL, c-FLIPS). Pharmacological preconditioning uses a phosphodiestrase inhibitor, another mode of protecting stem cell or heart per se from impending ischemic injury in two phases. During the early phase of cardioprotection (2 h), PC leads to increased expression of survival factors like BCl2/Bax ratio while late phase (24 h) showed activation of the JAK/STAT survival pathway. Phosphorylation of STAT3 at two crucial residues, Tyr-705 and Ser-727, allows its entry inside the nucleus and upregulates the expression of protein kinase G-1 (PKG1) which evokes cardioprotective signaling. To confirm, heart-specific conditional STAT3 knockout mice undergone IR surgery, abolishing late-phase cardioprotective effects.
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Affiliation(s)
- Manju Yadav
- Department of Biochemistry, Central University of Haryana, Mahendergarh, Haryana, India
| | - Pooja Kumari
- Department of Biochemistry, Central University of Haryana, Mahendergarh, Haryana, India
| | - Varsha Yadav
- Department of Biochemistry, Central University of Haryana, Mahendergarh, Haryana, India
| | - Sanjay Kumar
- Department of Biochemistry, Central University of Haryana, Mahendergarh, Haryana, India.
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 4110 Libra Drive, Bld 20, Orlando, FL, 32816, USA.
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Irfan AB, Arab C, DeFilippis AP, Lorkiewicz P, Keith RJ, Xie Z, Bhatnagar A, Carll AP. Smoking Accelerates Atrioventricular Conduction in Humans Concordant with Increased Dopamine Release. Cardiovasc Toxicol 2021; 21:169-178. [PMID: 33043409 PMCID: PMC7855806 DOI: 10.1007/s12012-020-09610-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/01/2020] [Indexed: 01/12/2023]
Abstract
Smoking is associated with cardiac arrhythmia, stroke, heart failure, and sudden cardiac arrest, all of which may derive from increased sympathetic influence on cardiac conduction system and altered ventricular repolarization. However, knowledge of the effects of smoking on supraventricular conduction, and the role of the sympathetic nervous system in them, remains incomplete. Participants with intermediate-high cardiovascular disease risk were measured for urinary catecholamines and cotinine, and 12-lead electrocardiograms (ECGs) were measured for atrial and atrioventricular conduction times, including P duration, PR interval, and PR segment (lead II), which were analyzed for associations with cotinine by generalized linear models. Statistical mediation analyses were then used to test whether any significant associations between cotinine and atrioventricular conduction were mediated by catecholamines. ECG endpoints and urinary metabolites were included from a total of 136 participants in sinus rhythm. Atrial and atrioventricular conduction did not significantly differ between smokers (n = 53) and non-smokers (n = 83). Unadjusted and model-adjusted linear regressions revealed cotinine significantly and inversely associated with PR interval and PR segment, but not P duration. Dopamine, norepinephrine, and epinephrine all inversely associated with PR interval, whereas only dopamine was also inversely associated with PR segment (p < 0.05). Dopamine and norepinephrine (but not epinephrine) also associated positively with cotinine. Dopamine mediated the relationship between cotinine and PR interval, as well as the relationship between cotinine and PR segment. Smoking is associated with accelerated atrioventricular conduction and elevated urinary dopamine and norepinephrine. Smoking may accelerate atrioventricular nodal conduction via increased dopamine production.
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Affiliation(s)
- Affan B Irfan
- Department of Physiology, University of Louisville, Louisville, KY, USA
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
| | - Claudia Arab
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Graduate Program in Cardiology, Federal University of São Paulo, São Paulo, Brazil
| | - Andrew P DeFilippis
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA
| | - Pawel Lorkiewicz
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA
| | - Rachel J Keith
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA
| | - Zhengzhi Xie
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA
| | - Alex P Carll
- Department of Physiology, University of Louisville, Louisville, KY, USA.
- Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA.
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA.
- American Heart Association-Tobacco Regulatory and Addiction Center, Dallas, TX, USA.
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Relationship between Plasma Adiponectin Level and Corrected QT Interval in Smoker and Non-smoker Adult Male Subjects. J ASEAN Fed Endocr Soc 2021; 35:190-195. [PMID: 33442191 PMCID: PMC7784200 DOI: 10.15605/jafes.035.02.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/02/2020] [Indexed: 11/17/2022] Open
Abstract
Objective This study determined the relationship between plasma adiponectin level and corrected QT interval (QTc) in smokers and non-smokers. Methodology This cross-sectional analytical study was undertaken in 30 smokers and 30 non-smokers. Plasma adiponectin level was determined by enzyme-linked immunosorbent assay (ELISA). The QT interval was measured by routine 12-lead ECG with Lead II rhythm and QTc was calculated. Results Mean plasma adiponectin level was significantly lower in smokers (27.89±15 μg/ml) than that of non-smokers (52.13±21.57pg/ml) (p<0.001). Mean QTc interval was significantly longer in smokers than that of non-smokers (415.37±29.9 versus 395.63±26.13 ms, p<0.01). Higher risk of low adiponectin level (odds ratio [OR],8.1; 95% confidence interval [CI],1.61-40.77) and QTc interval prolongation (OR,6; 95%CI,1.17-30.73) were observed in smokers. There was weak significant negative correlation between plasma adiponectin level and QTc interval in the study population (n=60, r=-0.407, p=0.001). Moreover, low plasma adiponectin level was significantly associated with prolonged QTc interval in the study population (n=60, Fisher's exact p value<0.05). Risk of QTc interval prolongation was 4.3 times higher in subjects with low plasma adiponectin level (OR,4.27; 95% CI,1.05-17.46). Conclusion Smokers have greater risk for low plasma adiponectin level and prolonged QTc interval. There is a relationship between plasma adiponectin level and QTc interval.
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Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights. Circ Res 2020; 127:4-20. [PMID: 32716709 DOI: 10.1161/circresaha.120.316340] [Citation(s) in RCA: 682] [Impact Index Per Article: 170.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Accompanying the aging of populations worldwide, and increased survival with chronic diseases, the incidence and prevalence of atrial fibrillation (AF) are rising, justifying the term global epidemic. This multifactorial arrhythmia is intertwined with common concomitant cardiovascular diseases, which share classical cardiovascular risk factors. Targeted prevention programs are largely missing. Prevention needs to start at an early age with primordial interventions at the population level. The public health dimension of AF motivates research in modifiable AF risk factors and improved precision in AF prediction and management. In this review, we summarize current knowledge in an attempt to untangle these multifaceted associations from an epidemiological perspective. We discuss disease trends, preventive opportunities offered by underlying risk factors and concomitant disorders, current developments in diagnosis and risk prediction, and prognostic implications of AF and its complications. Finally, we review current technological (eg, eHealth) and methodological (artificial intelligence) advances and their relevance for future prevention and disease management.
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Affiliation(s)
- Jelena Kornej
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts & Sections of Cardiovascular Medicine and Preventive Medicine, Boston Medical Center (J.K., E.J.B.), Boston University School of Medicine, MA
| | - Christin S Börschel
- Department of General and Interventional Cardiology, University Heart & Vascular Center Hamburg Eppendorf, Hamburg, Germany (C.B., R.B.S.)
- German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck (C.B., R.B.S.)
| | - Emelia J Benjamin
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts & Sections of Cardiovascular Medicine and Preventive Medicine, Boston Medical Center (J.K., E.J.B.), Boston University School of Medicine, MA
- Department of Epidemiology (E.J.B.), Boston University School of Medicine, MA
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart & Vascular Center Hamburg Eppendorf, Hamburg, Germany (C.B., R.B.S.)
- German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck (C.B., R.B.S.)
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Acute effect of cigarette smoking on frontal planar QRS-T angle in apparently healthy subjects with habitual smoking. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.641533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Özdemir L, Sökmen E. Effect of habitual cigarette smoking on the index of cardiac electrophysiological balance in apparently healthy individuals. J Electrocardiol 2020; 59:41-44. [PMID: 31958651 DOI: 10.1016/j.jelectrocard.2020.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/22/2019] [Accepted: 01/03/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Chronic cigarette smoking has been suggested to portend risk for cardiac arrhythmia generation. Index of cardiac electrophysiological balance (iCEB) is a relatively new ECG parameter indicating balance between ventricular depolarization and repolarization, thereby providing more insight concerning ventricular arrhythmogenesis (VA) than other classical ECG parameters such as QT and corrected QT (QTc) intervals. The present study aimed to assess the status of iCEB in healthy habitual smokers. METHODS This retrospective study included a total of 80 apparently healthy subjects (45% female, mean age 39.4 ± 8.1 years) with smoking habit and 82 healthy non-smoking subjects (40% female, mean age 37.0 ± 8.6 years) were included between January-September 2019. Demographic, clinical and ECG characteristics were obtained from medical records. iCEB and corrected iCEB values were calculated by dividing respective QT and QTc intervals by QRS duration. RESULTS Mean PR, QRS and QT intervals were similar between the groups, whereas mean heart rate and QTc interval were greater in the smoker group compared with the non-smokers [(82.0 ± 8.9 bpm vs 77.8 ± 12.4 bpm, respectively, p = 0.016) and (427.05 ± 22.6 msec vs 399.9 ± 12.8 msec, respectively, p < 0.001)]. Subject with smoking habit had greater iCEBc than the controls (5.10 ± 0.49 vs 4.68 ± 0.39, respectively, p < 0.001). However, there was no significant difference in regard of iCEB between the groups (4.37 ± 0.46 vs 4.32 ± 0.42, respectively, p = 0.456). CONCLUSION iCEBc increases significantly in healthy smokers compared with non-smokers. This may suggest an increased predisposition to Torsades de Pointes-mediated VA in healthy smokers, or in chronic smokers with inherent QT-prolonging genetic variations or those on QT-prolonging drug therapy.
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Affiliation(s)
- Levent Özdemir
- Department of Cardiology, Kırşehir Ahi Evran University Education and Research Hospital, Kırşehir, Turkey
| | - Erdoğan Sökmen
- Department of Cardiology, Kırşehir Ahi Evran University Education and Research Hospital, Kırşehir, Turkey.
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Strickland M, Yacoubi-Loueslati B, Bouhaouala-Zahar B, Pender SLF, Larbi A. Relationships Between Ion Channels, Mitochondrial Functions and Inflammation in Human Aging. Front Physiol 2019; 10:158. [PMID: 30881309 PMCID: PMC6405477 DOI: 10.3389/fphys.2019.00158] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/08/2019] [Indexed: 12/19/2022] Open
Abstract
Aging is often associated with a loss of function. We believe aging to be more an adaptation to the various, and often continuous, stressors encountered during life in order to maintain overall functionality of the systems. The maladaptation of a system during aging may increase the susceptibility to diseases. There are basic cellular functions that may influence and/or are influenced by aging. Mitochondrial function is amongst these. Their presence in almost all cell types makes of these valuable targets for interventions to slow down or even reserve signs of aging. In this review, the role of mitochondria and essential physiological regulators of mitochondria and cellular functions, ion channels, will be discussed in the context of human aging. The origins of inflamm-aging, associated with poor clinical outcomes, will be linked to mitochondria and ion channel biology.
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Affiliation(s)
- Marie Strickland
- Singapore Immunology Network, Agency for Science Technology and Research, Singapore, Singapore
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Besma Yacoubi-Loueslati
- Laboratory of Mycology, Pathologies and Biomarkers, Department of Biology, Faculty of Sciences, University Tunis El Manar, Tunis, Tunisia
| | - Balkiss Bouhaouala-Zahar
- Laboratory of Venoms and Therapeutic Molecules, Institut Pasteur de Tunis, University Tunis El Manar, Tunis, Tunisia
- Medical School of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Sylvia L. F. Pender
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Chinese University of Hong Kong – University of Southampton Joint Lab for Stem Cell and Regenerative Medicine, Hong Kong, China
| | - Anis Larbi
- Singapore Immunology Network, Agency for Science Technology and Research, Singapore, Singapore
- Department of Biology, Faculty of Sciences, University Tunis El Manar, Tunis, Tunisia
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatrics Division, Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
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Irfan A, Li Y, Bhatnagar A, Soliman EZ. Association between serum cotinine levels and electrocardiographic left atrial abnormality. Ann Noninvasive Electrocardiol 2018; 24:e12586. [PMID: 30152127 DOI: 10.1111/anec.12586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/22/2018] [Accepted: 06/23/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Although the harmful effect of tobacco exposure on cardiovascular disease (CVD) and its risk factors are well established, the constituents of cigarette-smoke and the pathophysiological mechanism involved are unknown. Recently, deep terminal negativity of P wave in V1 (DTNPV1) has emerged as a marker of left atrial abnormality that predicts atrial fibrillation, stroke, and death due to all-cause or CVD. Therefore, we examined the association between serum cotinine levels with abnormal DTNPV1 using the Third National Health and Nutrition Examination Survey. METHODS This analysis included 4,507 participants (mean age 58 ± 13 years, 53% women, 49% non-Hispanic white) of NHANES III, without history of CVD or major electrocardiographic abnormalities and not on heart rate modifying medications. Multivariable logistic regression analysis was used to examine the association between serum cotinine and abnormal DTNPV1-defined from automatically processed electrocardiograms as values of the amplitude of the terminal negative phase of P wave in lead V1 exceeding 100 μV. RESULTS Abnormal DTNPV1 was detected in 2.3% (n = 105) of the participants. In a model adjusted for demographics and CVD risk factors, each 10 ng/ml serum cotinine was associated with 2% increased odds of abnormal DTNPV1 (odds ratio 1.02, 95% confidence interval 1.01-1.03, p-value < 0.001). This association was consistent in subgroups stratified by age, sex, race, smoking status, hypertension, diabetes, dyslipidemia, and chronic obstructive pulmonary disease. CONCLUSION Elevated serum cotinine levels are associated with an abnormal DTNPV1. This suggests that nicotine exposure can lead to left atrial abnormalities, a possible mechanism for increased risk of CVD.
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Affiliation(s)
- Affan Irfan
- Department of Cardiology Services and Department of Clinical & Translational Sciences, Marshall University, Huntington, West Virginia.,Department of Physiology, University of Louisville, Louisville, Kentucky.,Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Yabing Li
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina.,Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina
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Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies. Eur J Prev Cardiol 2018; 25:1437-1451. [DOI: 10.1177/2047487318780435] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Epidemiological studies on smoking and atrial fibrillation have been inconsistent, with some studies showing a positive association while others have found no association. It is also unclear whether there is a dose–response relationship between the number of cigarettes smoked or pack-years and the risk of atrial fibrillation. We conducted a systematic review and meta-analysis to clarify the association. Design Systematic review and meta-analysis. Methods We searched the PubMed and Embase databases for studies of smoking and atrial fibrillation up to 20 July 2017. Prospective studies and nested case–control studies within cohort studies reporting adjusted relative risk estimates and 95% confidence intervals (CIs) of atrial fibrillation associated with smoking were included. Summary relative risks (95% CIs) were estimated using a random effects model. Results Twenty nine prospective studies (22 publications) were included. The summary relative risk was 1.32 (95% CI 1.12–1.56, I2 = 84%, n = 11 studies) for current smokers, 1.09 (95% CI 1.00–1.18, I2 = 33%, n = 9) for former smokers and 1.21 (95% CI 1.12–1.31, I2 = 80%, n = 14) for ever smokers compared to never smokers. Comparing current versus non-current smokers the summary relative risk was 1.33 (95% CI 1.14–1.56, I2 = 78%, n = 10). The summary relative risk was 1.14 (95% CI 1.10–1.20, I2 = 0%, n = 3) per 10 cigarettes per day and 1.16 (95% CI 1.09–1.25, I2 = 49%, n = 2) per 10 pack-years and there was no evidence of a non-linear association for cigarettes per day, Pnon-linearity = 0.17. Conclusions The current meta-analysis suggests that smoking is associated with an increased risk of atrial fibrillation in a dose-dependent matter, but the association is weaker among former smokers compared to current smokers.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, Imperial College London, UK
- Department of Nutrition, Bjørknes University College, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| | - Sabrina Schlesinger
- Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, UK
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Inhaled nicotine equivalent to cigarette smoking disrupts systemic and uterine hemodynamics and induces cardiac arrhythmia in pregnant rats. Sci Rep 2017; 7:16974. [PMID: 29209071 PMCID: PMC5717237 DOI: 10.1038/s41598-017-17301-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/23/2017] [Indexed: 01/09/2023] Open
Abstract
Maternal smoking with obligatory nicotine inhalation is associated with preterm delivery, low birth weight, fetal growth retardation and developmental defects. We tested the hypothesis that cigarette smoking-relevant nicotine inhalation during pregnancy impairs cardiovascular function and uterine hemodynamics with consequential fetal ischemia. Pregnant rats exposed to episodic inhaled nicotine via a novel lung alveolar region-targeted aerosol method produced nicotine pharmacokinetics resembling cigarette smoking in humans. This clinically relevant nicotine aerosol inhalation (NAI) induced transient reduction and irregular fluctuations in uterine artery blood flow associated with cardiac arrhythmia and high magnitude irregular fluctuations of systemic blood pressure. The arrhythmia included sinoatrial (SA) block, sinus arrest, 2° and 3° atrioventricular (A-V) block and supraventricular escape rhythm. These effects were blocked by the nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine. Resection of the ovarian nerve, which innervates uterine blood vessels, counteracted the NAI-induced reduction in uterine blood flow. We suggest that the rapid rise pattern of arterial blood nicotine concentration stimulates and then desensitizes autonomic nAChRs leading to disruptions of cardiac function as well as systemic and uterine hemodynamics that reduces uteroplacental blood flow, a mechanism underlying maternal smoking-associated pregnancy complications and developmental disorders. These findings challenge the safety of pure nicotine inhalation, i.e., E-cigarettes.
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Bébarová M, Horáková Z, Kula R. Addictive drugs, arrhythmias, and cardiac inward rectifiers. Europace 2017; 19:346-355. [PMID: 27302393 DOI: 10.1093/europace/euw071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/20/2016] [Indexed: 12/30/2022] Open
Abstract
In many addictive drugs including alcohol and nicotine, proarrhythmic effects were reported. This review provides an overview of the current knowledge in this field (with a focus on the inward rectifier potassium currents) to promote the lacking data and appeal for their completion, thus, to improve understanding of the proarrhythmic potential of addictive drugs.
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Imtiaz Ahmad M, Mosley CD, O'Neal WT, Judd SE, McClure LA, Howard VJ, Howard G, Soliman EZ. Smoking and risk of atrial fibrillation in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. J Cardiol 2017; 71:113-117. [PMID: 28886993 DOI: 10.1016/j.jjcc.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Whether smoking increases the risk of atrial fibrillation (AF) remains debatable due to inconsistent reports. METHODS We examined the association between smoking and incident AF in 11,047 participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, one of the largest biracial, population-based cohort studies in the USA. Baseline (2003-2007) cigarette smoking status and amount (pack-years) were self-reported. Incident AF was determined by electrocardiography and history of a prior physician diagnosis at a follow-up examination conducted after a median of 10.6 years. RESULTS During follow-up, 954 incident AF cases were identified; 9.5% in smokers vs. 7.8% in non-smokers; p<0.001. In a model adjusted for socio-demographics, smoking (ever vs. never) was associated with a 15% increased risk of AF [OR (95%CI): 1.15(1.00, 1.31)], but this association was no longer significant after further adjustment for cardiovascular risk factors [OR (95% CI): 1.12 (0.97, 1.29)]. However, heterogeneities in the association were observed among subgroups; the association was stronger in young vs. old participants [OR (95%CI): 1.31 (1.03, 1.67) vs. 0.99 (0.83-1.18) respectively; interaction p-value=0.005] and in those with vs. without prior cardiovascular disease [OR (95%CI): 1.18 (0.90, 1.56) vs. 1.06 (0.90, 1.25) respectively; interaction p-value 0.0307]. Also, the association was significant in blacks but not in whites [OR (95%CI): 1.51 (1.12, 2.05) vs. 0.99 (0.84, 1.16), respectively], but the interaction p-value did not reach statistical significance (interaction p-value=0.65). CONCLUSIONS The association between smoking and AF is possibly mediated by a higher prevalence of cardiovascular risk factors in smokers, but there is marked heterogeneity in the strength of this association among subgroups which may explain the conflicting results in prior studies.
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Affiliation(s)
- Muhammad Imtiaz Ahmad
- Department of Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Candice D Mosley
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Abstract
The past 3 decades have been characterized by an exponential growth in knowledge and advances in the clinical treatment of atrial fibrillation (AF). It is now known that AF genesis requires a vulnerable atrial substrate and that the formation and composition of this substrate may vary depending on comorbid conditions, genetics, sex, and other factors. Population-based studies have identified numerous factors that modify the atrial substrate and increase AF susceptibility. To date, genetic studies have reported 17 independent signals for AF at 14 genomic regions. Studies have established that advanced age, male sex, and European ancestry are prominent AF risk factors. Other modifiable risk factors include sedentary lifestyle, smoking, obesity, diabetes mellitus, obstructive sleep apnea, and elevated blood pressure predispose to AF, and each factor has been shown to induce structural and electric remodeling of the atria. Both heart failure and myocardial infarction increase risk of AF and vice versa creating a feed-forward loop that increases mortality. Other cardiovascular outcomes attributed to AF, including stroke and thromboembolism, are well established, and epidemiology studies have championed therapeutics that mitigate these adverse outcomes. However, the role of anticoagulation for preventing dementia attributed to AF is less established. Our review is a comprehensive examination of the epidemiological data associating unmodifiable and modifiable risk factors for AF and of the pathophysiological evidence supporting the mechanistic link between each risk factor and AF genesis. Our review also critically examines the epidemiological data on clinical outcomes attributed to AF and summarizes current evidence linking each outcome with AF.
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Affiliation(s)
- Laila Staerk
- Cardiovascular Research Centre, Herlev and Gentofte University Hospital, Copenhagen, Denmark
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States
- Boston University and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, United States
| | - Jason A. Sherer
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Darae Ko
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, United States
- Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Emelia J. Benjamin
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States
- Boston University and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, United States
- Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, United States
- Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
- Section of Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Robert H. Helm
- Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States
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Nicotine at clinically relevant concentrations affects atrial inward rectifier potassium current sensitive to acetylcholine. Naunyn Schmiedebergs Arch Pharmacol 2017; 390:471-481. [DOI: 10.1007/s00210-017-1341-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
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Kokubo Y, Watanabe M, Higashiyama A, Nakao YM, Kusano K, Miyamoto Y. Development of a Basic Risk Score for Incident Atrial Fibrillation in a Japanese General Population ― The Suita Study ―. Circ J 2017; 81:1580-1588. [DOI: 10.1253/circj.cj-17-0277] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshihiro Kokubo
- Department of Preventive Medicine, National Cerebral and Cardiovascular Center
| | - Makoto Watanabe
- Department of Preventive Medicine, National Cerebral and Cardiovascular Center
| | - Aya Higashiyama
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
| | - Yoko M Nakao
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshihiro Miyamoto
- Department of Preventive Medicine, National Cerebral and Cardiovascular Center
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
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Abstract
To prevent atrial fibrillation (AF), it is essential to reduce its risk factors and extend healthy life expectancy as a result. There are few reviews on the AF risk factors. We discuss them and approach the prevention of AF. We briefly review traditional risk factors for incident AF, especially focusing on high blood pressure, overweight/obesity, dyslipidemia, diabetes, tobacco smoking, and excessive drinking. When trying to prevent AF by modifying lifestyle, it is important to comprehensively utilize the risk factors for AF to predict the 10-year as an AF risk score. However, there are only 2 risk scores of AF just for the US population. There are few studies of the AF risk factors in non-Western populations. A risk score for incident AF in non-Westerners is awaited because different race and lifestyles may have different contributions as AF risk factors. An AF risk score in accordance with race could be useful for identifying persons with a high risk of AF in order to encourage them to consult a doctor and encourage lifestyle modifications before the onset of AF. (Circ J 2016; 80: 2415-2422).
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Affiliation(s)
- Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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Jena SS, Kabi S, Panda BN, Kameswari BC, Payal, Behera IC, Tripathy SK, Mahanta S. Smokeless Tobacco and Stroke - A Clinico-epidemiological Follow-up Study in A Tertiary Care Hospital. J Clin Diagn Res 2016; 10:OC40-OC43. [PMID: 27891376 DOI: 10.7860/jcdr/2016/21763.8756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/15/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Among the modifiable risk factors for stroke, tobacco smoking is well recognized. In some studies the use of Smokeless Tobacco (ST) has also been contributed as a risk factor for ischemic stroke. Use of ST is very common in South-East Asia. The form of ST varies according to the geographical and cultural variation. AIM To study the various clinical symptoms and radiological findings of stroke due to different types of ST. MATERIALS AND METHODS This was a prospective hospital based study carried out over a period of 2 years. All the cases within age group of 16 - 60 years and with a clinical and radiological diagnosis of acute stroke were included in the study. The Fagerström Test for Nicotine Dependence for ST of more than 6 was taken as the inclusion criteria. Patients having other addictions like smoked tobacco, alcohol, etc., and with important risk factors like hypertension, diabetes, dyslipidemia were excluded. The cases were extensively investigated and followed up for at least 6 months. Analysis was done using the Statistical Package for Social Sciences (SPSS- version 16.0). Descriptive statistics like percentage, mean were used wherever appropriate. RESULTS During a period of 2 years, a total of 54 patients were studied. Forty two (77.7%) were males and 12(22.3%) were females. The mean age at presentation was 42.72(± 8.6) years and among all 96.3% patients were diagnosed as ischemic stroke. Among ST, pan was most commonly used in 21(38.9%) patients with an average of 14.6(±3.27) years of addiction. Hemiplegia was the predominant symptom on presentation (46, 85.2%). According to Oxfordshire Stroke Classification, partial anterior circulation infarct was most common in 20(38.4%). The mean Modified Rankin scale after 5 days of hospital stay was 3.83(±1.03) and after 6 months of follow-up was 2.1(±0.8). Patients were counseled for deaddiction and after 6 months follow-up 48(88.8%) patients had quit ST. CONCLUSION ST is an important etiological factor for young ischemic stroke. This is the first study depicting clinical symptomatology of ST addicted ischemic stroke patients from India. Considering the increasing prevalence of ST use in south-east Asia, further long term studies are needed from this region.
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Affiliation(s)
- Subhransu Sekhar Jena
- Associate Professor, Department of Neurology, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Shobhitendu Kabi
- Associate Professor, Department of Medicine, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Baikuntha Nath Panda
- Professor, Department of Medicine, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - B C Kameswari
- Student, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Payal
- Student, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Ishwar Chandra Behera
- Associate Professor, Department of Emergency and Critical Care, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Subrat Kumar Tripathy
- Assistant Professor, Department of Biochemistry, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
| | - Seemanchana Mahanta
- Junior Resident, Department of Neurology, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India
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Zhu W, Yuan P, Shen Y, Wan R, Hong K. Association of smoking with the risk of incident atrial fibrillation: A meta-analysis of prospective studies. Int J Cardiol 2016; 218:259-266. [PMID: 27236125 DOI: 10.1016/j.ijcard.2016.05.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 04/15/2016] [Accepted: 05/12/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several studies have investigated the role of smoking in incident atrial fibrillation (AF) but have reported contradictory results. Identifying the quantitative association between smoking and AF risk is important for AF management and prevention; therefore, we aimed to estimate the association of smoking with incident AF. METHODS We systematically retrieved relevant studies reporting on the association between smoking and AF using the Cochrane Library, PubMed, and Embase databases. The data were extracted from applicable articles, and we used a random effects model to pool the effect estimates. RESULTS Sixteen prospective studies with an overall number of 286,217 participants and 11,878 AF cases met the inclusion criteria. A higher prevalence of AF was confirmed among smokers (risk ratio [RR]=1.23, 95% confidence interval [CI] 1.08-1.39; P=0.001). These results were stable in the sensitivity analysis. The pooled RRs showed consistent positive associations in most subgroups. Specifically, 8 articles compared both current smokers (RR=1.39, 95% CI 1.11-1.75) and former smokers (RR=1.16, 95% CI: 1.00-1.36) with never smokers. Four articles compared ever smokers (pooled RR=1.21, 95% CI 0.93-1.57) with never smokers, and 7 articles compared current smokers (pooled RR=1.21, 95% CI 1.03-1.42) with non-current smokers. Additionally, we estimated that 6.7% of the total risk of AF in men and 1.4% of the risk in women were attributable to smoking worldwide. CONCLUSIONS Based on the published literature, smoking is associated with a modest increased risk of incident AF. Smoking cessation seemed to reduce but not entirely eliminate the excess risk of AF.
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Affiliation(s)
- Wengen Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospial of Nanchang University, Nanchang of Jiangxi, 330006, China
| | - Ping Yuan
- Department of Cardiovascular Medicine, The Second Affiliated Hospial of Nanchang University, Nanchang of Jiangxi, 330006, China
| | - Yang Shen
- Department of Cardiovascular Medicine, The Second Affiliated Hospial of Nanchang University, Nanchang of Jiangxi, 330006, China
| | - Rong Wan
- Jiangxi Key Laboratory of Molecular Medicine, Nanchang of Jiangxi 330006, China
| | - Kui Hong
- Department of Cardiovascular Medicine, The Second Affiliated Hospial of Nanchang University, Nanchang of Jiangxi, 330006, China; Jiangxi Key Laboratory of Molecular Medicine, Nanchang of Jiangxi 330006, China.
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White SH, Sturgeon RM, Magoski NS. Nicotine inhibits potassium currents in Aplysia bag cell neurons. J Neurophysiol 2016; 115:2635-48. [PMID: 26864763 DOI: 10.1152/jn.00816.2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 02/09/2016] [Indexed: 11/22/2022] Open
Abstract
Acetylcholine and the archetypal cholinergic agonist, nicotine, are typically associated with the opening of ionotropic receptors. In the bag cell neurons, which govern the reproductive behavior of the marine snail, Aplysia californica, there are two cholinergic responses: a relatively large acetylcholine-induced current and a relatively small nicotine-induced current. Both currents are readily apparent at resting membrane potential and result from the opening of distinct ionotropic receptors. We now report a separate current response elicited by applying nicotine to cultured bag cell neurons under whole cell voltage-clamp. This current was ostensibly inward, best resolved at depolarized voltages, presented a noncooperative dose-response with a half-maximal concentration near 1.5 mM, and associated with a decrease in membrane conductance. The unique nicotine-evoked response was not altered by intracellular perfusion with the G protein blocker GDPβS or exposure to classical nicotinic antagonists but was occluded by replacing intracellular K(+) with Cs(+) Consistent with an underlying mechanism of direct inhibition of one or more K(+) channels, nicotine was found to rapidly reduce the fast-inactivating A-type K(+) current as well as both components of the delayed-rectifier K(+) current. Finally, nicotine increased bag cell neuron excitability, which manifested as reduction in spike threshold, greater action potential height and width, and markedly more spiking to continuous depolarizing current injection. In contrast to conventional transient activation of nicotinic ionotropic receptors, block of K(+) channels could represent a nonstandard means for nicotine to profoundly alter the electrical properties of neurons over prolonged periods of time.
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Affiliation(s)
- Sean H White
- Department of Biomedical and Molecular Sciences, Physiology Graduate Program, Queen's University, Kingston, Ontario, Canada
| | - Raymond M Sturgeon
- Department of Biomedical and Molecular Sciences, Physiology Graduate Program, Queen's University, Kingston, Ontario, Canada
| | - Neil S Magoski
- Department of Biomedical and Molecular Sciences, Physiology Graduate Program, Queen's University, Kingston, Ontario, Canada
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Abstract
Any disturbance of electrical impulse formation in the heart and of impulse conduction or action potential (AP) repolarization can lead to rhythm disorders. Potassium (K(+)) channels play a prominent role in the AP repolarization process. In this review we describe the causes and mechanisms of proarrhythmic effects that arise as a response to blockers of cardiac K(+) channels. The largest and chemically most diverse groups of compound targets are Kv11.1 (hERG) and Kv7.1 (KvLQT1) channels. Finally, the proarrhythmic propensity of atrial-selective K(+) blockers inhibiting Kv1.5, Kir3.1/3.4, SK, and K2P channels is discussed.
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Affiliation(s)
- Lasse Skibsbye
- Danish Arrhythmia Research Centre, Faculty of Health and Medical Sciences, University of Copenhagen, 3 Blegdamsvej, 3 Copenhagen N DK-2200, Denmark
| | - Ursula Ravens
- Department of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Institut für Pharmakologie und Toxikologie, TU Dresden, Fetscherstrasse 74, Dresden D-01307, Germany.
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Boles U, Baranchuk A. Brugada Phenocopy or Unmasked Brugada Syndrome? Relevance of the Provocation Test. J Emerg Med 2016; 50:782. [PMID: 26906547 DOI: 10.1016/j.jemermed.2015.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 11/13/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Usama Boles
- Division of Cardiology, Electrophysiology and Pacing, Queen's University, Kingston General Hospital Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Division of Cardiology, Electrophysiology and Pacing, Queen's University, Kingston General Hospital Kingston, Ontario, Canada
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Type 1 Brugada Pattern Associated with Nicotine Toxicity. J Emerg Med 2015; 49:e183-6. [DOI: 10.1016/j.jemermed.2015.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 07/07/2015] [Accepted: 08/13/2015] [Indexed: 01/31/2023]
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Effects of neferine on Kv4.3 channels expressed in HEK293 cells and ex vivo electrophysiology of rabbit hearts. Acta Pharmacol Sin 2015; 36:1451-61. [PMID: 26592512 DOI: 10.1038/aps.2015.83] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/26/2015] [Indexed: 01/16/2023] Open
Abstract
AIM Neferine is an isoquinoline alkaloid isolated from seed embryos of Nelumbo nucifera (Gaertn), which has a variety of biological activities. In this study we examined the effects of neferine on Kv4.3 channels, a major contributor to the transient outward current (I(to)) in rabbit heart, and on ex vivo electrophysiology of rabbit hearts. METHODS Whole-cell Kv4.3 currents were recorded in HEK293 cells expressing human cardiac Kv4.3 channels using patch-clamp technique. Arterially perfused wedges of rabbit left ventricles (LV) were prepared, and transmembrane action potentials were simultaneously recorded from epicardial (Epi) and endocardial (Endo) sites with floating microelectrodes together with transmural electrocardiography (ECG). RESULTS Neferine (0.1-100 μmol/L) dose-dependently and reversibly inhibited Kv4.3 currents (the IC50 value was 8.437 μmol/L, and the maximal inhibition at 100 μmol/L was 44.12%). Neferine (10 μmol/L) caused a positive shift of the steady-state activation curve of Kv4.3 currents, and a negative shift of the steady-state inactivation curve. Furthermore, neferine (10 μmol/L) accelerated the inactivation but not the activation of Kv4.3 currents, and markedly slowed the recovery of Kv4.3 currents from inactivation. Neferine-induced blocking of Kv4.3 currents was frequency-dependent. In arterially perfused wedges of rabbit LV, neferine (1, 3, and 10 μmol/L) dose-dependently prolonged the QT intervals and action potential durations (APD) at both Epi and Endo sites, and caused dramatic increase of APD10 at Epi sites. CONCLUSION Neferine inhibits Kv4.3 channels likely by blocking the open state and inactivating state channels, which contributes to neferine-induced dramatic increase of APD10 at Epi sites of rabbit heart.
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Joukar S, Sheibani V, Koushesh F, Ghasemipoor Afshar E, Ghorbani Shahrbabaki S. Arrhythmogenic Risk Assessment Following Four-Week Pretreatment With Nicotine and Black Tea in Rat. Res Cardiovasc Med 2015; 4:e27088. [PMID: 26436072 PMCID: PMC4588709 DOI: 10.5812/cardiovascmed.27088v2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 03/10/2015] [Accepted: 03/16/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is the controversy concerning the main component of tobacco, which is responsible for its arrhythmogenesis. In addition, there is the lack of adequate information about the influence of combination of black tea and nicotine on heart rhythm. OBJECTIVES This study aimed to examine whether pretreatment with black tea and nicotine could modulate the susceptibility to lethal ventricular arrhythmias. MATERIALS AND METHODS Animals were randomized to control, black tea, nicotine, and black tea plus nicotine groups. Test groups were treated with black tea brewed (orally) and nicotine (2 mg/kg, subcutaneous), alone and in combination for four weeks. On day 29, aconitine was infused intravenously for induction of cardiac arrhythmia. RESULTS In comparison with the control group, each of tea and nicotine significantly decreased the duration of the ventricular tachycardia (VT) plus ventricular fibrillation (VF) and the score of arrhythmia severity (P < 0.05 and P < 0.01, respectively,). The latency for the first VT event was significantly longer in the all test groups, but VF latency was significant only in tea and nicotine groups compared with control group (P < 0.05 and P < 0.01, respectively).Threshold dose of aconitine for inducing VT and VF increased in all test groups, but only VT showed a significant difference in comparison to the control group (P < 0.001). CONCLUSIONS The findings suggest that sub-chronic consumption of nicotine or black tea alone with appropriate doses could potentially be antiarrhythmic and its combination regimen does not increase the risk of fatal ventricular arrhythmias during four-week consumption period in rats.
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Affiliation(s)
- Siyavash Joukar
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
- Corresponding author: Siyavash Joukar, Department of Physiology, Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran. Tel/Fax: +98-3413220081, E-mail:
| | - Vahid Sheibani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Faramarz Koushesh
- School of Allied Medical Sciences, Bushehr University of Medical Sciences, Bushehr, IR Iran
| | - Elham Ghasemipoor Afshar
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
- Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Soodabe Ghorbani Shahrbabaki
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
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Cil O, Esteva-Font C, Tas ST, Su T, Lee S, Anderson MO, Ertunc M, Verkman AS. Salt-sparing diuretic action of a water-soluble urea analog inhibitor of urea transporters UT-A and UT-B in rats. Kidney Int 2015; 88:311-20. [PMID: 25993324 PMCID: PMC4523423 DOI: 10.1038/ki.2015.138] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 03/10/2015] [Accepted: 03/26/2015] [Indexed: 11/09/2022]
Abstract
Inhibitors of kidney urea transporter (UT) proteins have potential use as salt-sparing diuretics ('urearetics') with a different mechanism of action than diuretics that target salt transporters. To study UT inhibition in rats, we screened about 10,000 drugs, natural products and urea analogs for inhibition of rat UT-A1. Drug and natural product screening found nicotine, sanguinarine and an indolcarbonylchromenone with IC50 of 10-20 μM. Urea analog screening found methylacetamide and dimethylthiourea (DMTU). DMTU fully and reversibly inhibited rat UT-A1 and UT-B by a noncompetitive mechanism with IC50 of 2-3 mM. Homology modeling and docking computations suggested DMTU binding sites on rat UT-A1. Following a single intraperitoneal injection of 500 mg/kg DMTU, peak plasma concentration was 9 mM with t1/2 of about 10 h, and a urine concentration of 20-40 mM. Rats chronically treated with DMTU had a sustained, reversible reduction in urine osmolality from 1800 to 600 mOsm, a 3-fold increase in urine output, and mild hypokalemia. DMTU did not impair urinary concentrating function in rats on a low protein diet. Compared to furosemide-treated rats, the DMTU-treated rats had greater diuresis and reduced urinary salt loss. In a model of syndrome of inappropriate antidiuretic hormone secretion, DMTU treatment prevented hyponatremia and water retention produced by water-loading in dDAVP-treated rats. Thus, our results establish a rat model of UT inhibition and demonstrate the diuretic efficacy of UT inhibition.
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Affiliation(s)
- Onur Cil
- 1] Departments of Medicine and Physiology, University of California, San Francisco, CA, USA [2] Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cristina Esteva-Font
- Departments of Medicine and Physiology, University of California, San Francisco, CA, USA
| | - Sadik Taskin Tas
- Department of Pharmacology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tao Su
- Departments of Medicine and Physiology, University of California, San Francisco, CA, USA
| | - Sujin Lee
- Departments of Medicine and Physiology, University of California, San Francisco, CA, USA
| | - Marc O Anderson
- Department of Chemistry and Biochemistry, San Francisco State University, San Francisco, CA, USA
| | - Mert Ertunc
- Department of Pharmacology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Alan S Verkman
- Departments of Medicine and Physiology, University of California, San Francisco, CA, USA
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Huo R, Sheng Y, Guo WT, Dong DL. The potential role of Kv4.3 K+ channel in heart hypertrophy. Channels (Austin) 2015; 8:203-9. [PMID: 24762397 DOI: 10.4161/chan.28972] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Transient outward K+ current (I(to)) plays a crucial role in the early phase of cardiac action potential repolarization. Kv4.3 K(+) channel is an important component of I(to). The function and expression of Kv4.3 K(+) channel decrease in variety of heart diseases, especially in heart hypertrophy/heart failure. Int his review, we summarized the changes of cardiac Kv4.3 K(+) channel in heart diseases and discussed the potential role of Kv4.3 K(+) channel in heart hypertrophy/heart failure. In heart hypertrophy/heart failure of mice and rats, down regulation of Kv4.3 K(+) channel leads to prolongation of action potential duration (APD), which is associated with increased [Ca(2+)](I), activation of calcineurin and heart hypertrophy/heart failure.However, in canine and human, Kv4.3 K(+) channel does not play a major role in setting cardiac APD. So, in addition to Kv4.3 K(+) channel/APD/[Ca(2+)](I) pathway, there exits another mechanism of Kv4.3 K(+) channel in heart hypertrophy and heart failure: downregulation of Kv4.3 K(+) channels leads to CaMKII dissociation from Kv4.3–CaMKII complex and subsequent activation of the dissociated CaMKII , which induces heart hypertrophy/heart failure. Upregulation of Kv4.3K(+) channel inhibits CaMKII activation and its related harmful consequences. We put forward a new point-of-view that Kv4.3 K(+) channel is involved in heart hypertrophy/heart failure independently of its electric function, and drugs inhibiting or upregulating Kv4.3 K(+) channel might be potentially harmful or beneficial to hearts through CaMKII.
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Chagué F, Guenancia C, Gudjoncik A, Moreau D, Cottin Y, Zeller M. Smokeless tobacco, sport and the heart. Arch Cardiovasc Dis 2014; 108:75-83. [PMID: 25497687 DOI: 10.1016/j.acvd.2014.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 11/24/2022]
Abstract
Smokeless tobacco (snuff) is a finely ground or shredded tobacco that is sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek. Smokeless tobacco is widely used by young athletes to enhance performance because nicotine improves some aspects of physiology. However, smokeless tobacco has harmful health effects, including cardiovascular disorders, linked to nicotine physiological effects, mainly through catecholamine release. Nicotine decreases heart rate variability and the ventricular fibrillation threshold, and promotes the occurrence of various arrhythmias; it also impairs endothelial-dependent vasodilation and could therefore promote premature atherogenesis. At rest, heart rate, blood pressure, inotropism, cardiac output and myocardial oxygen consumption are increased by nicotine, leading to an imbalance between myocardial oxygen demand and supply. The same occurs at submaximal levels of exercise. These increases are accompanied by a rise in systemic resistances. At maximal exercise, heart rate, cardiac output and maximal oxygen uptake (V˙O2max) are unaffected by nicotine. Because endothelial dysfunction is promoted by nicotine, paradoxical coronary vasoconstriction may occur during exercise and recovery. Nicotine induces a decrease in muscular strength and impairs anaerobic performance. However, nicotine is used in sports as it diminishes anxiety, enhances concentration and agility, improves aerobic performance and favours weight control. Importantly, smokeless tobacco, similar to cigarette smoking, leads to nicotine dependence through dopaminergic pathways. Smokeless tobacco has harmful cardiovascular effects and is addictive: it fulfils all the criteria for inclusion in the World Anti-Doping Agency prohibited list as a doping product. Smokeless tobacco use in sporting activities must be discouraged.
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Affiliation(s)
| | - Charles Guenancia
- Cardiology Department, CHU de Dijon, Dijon, France; Laboratory of Cardiometabolic Physiopathology and Pharmacology, INSERM U866, University of Burgundy, Dijon, France
| | | | - Daniel Moreau
- Laboratory of Cardiometabolic Physiopathology and Pharmacology, INSERM U866, University of Burgundy, Dijon, France
| | - Yves Cottin
- Cardiology Department, CHU de Dijon, Dijon, France; Laboratory of Cardiometabolic Physiopathology and Pharmacology, INSERM U866, University of Burgundy, Dijon, France
| | - Marianne Zeller
- Laboratory of Cardiometabolic Physiopathology and Pharmacology, INSERM U866, University of Burgundy, Dijon, France.
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Suzuki S, Otsuka T, Sagara K, Kano H, Matsuno S, Takai H, Kato Y, Uejima T, Oikawa Y, Nagashima K, Kirigaya H, Kunihara T, Yajima J, Sawada H, Aizawa T, Yamashita T. Association between smoking habits and the first-time appearance of atrial fibrillation in Japanese patients: Evidence from the Shinken Database. J Cardiol 2014; 66:73-9. [PMID: 25458170 DOI: 10.1016/j.jjcc.2014.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/27/2014] [Accepted: 09/08/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND We previously reported a cross-sectional analysis regarding the relationship between smoking and atrial fibrillation (AF) in a single hospital-based cohort with Japanese patients, but the effect of cessation of smoking and/or total tobacco consumption were unclear. METHODS AND RESULTS We used data from the Shinken Database 2004-2011 (men/women, n=10,714/6803, respectively), which included all new patients attending the Cardiovascular Institute between June 2004 and March 2012. After excluding those previously diagnosed with AF (n=2296), 15,221 patients (men/women, n=9016/6205) were analyzed. During the follow-up period of 2.0±2.1 years (range 0.0-8.1), the incidence rates of new AF in smokers and non-smokers were 9.0 and 5.0 per 1000 patient-years, respectively. In adjusted models with Cox regression analysis, smokers were independently associated with new AF [hazard ratio (HR) 1.47, 95% confidence interval (CI) 1.09-2.00]. Also, current smokers (HR 1.81, 95% CI 1.17-2.79) and smokers with Brinkman index ≥800 (HR 1.69, 95% CI 1.05-2.70) were independently associated with new AF. However, in current smokers, the HRs were not different by Brinkman index (Brinkman index <800/≥800; HR 1.81/1.82, 95% CI 1.07-3.05/0.94-3.51, respectively). CONCLUSIONS Smoking was independently associated with the first-appearance of AF in patients in sinus rhythm, especially when the patients continued their smoking habit. However, in patients who continued smoking, difference by total tobacco consumption was not observed, suggesting the significance of cessation of smoking for preventing AF. Our data are limited because of a single hospital-based nature and a relatively short observation period.
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Affiliation(s)
- Shinya Suzuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.
| | - Takayuki Otsuka
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Koichi Sagara
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hiroto Kano
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Shunsuke Matsuno
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hideaki Takai
- Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan
| | - Yuko Kato
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Tokuhisa Uejima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Yuji Oikawa
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Kazuyuki Nagashima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hajime Kirigaya
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Takashi Kunihara
- Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan
| | - Junji Yajima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hitoshi Sawada
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Tadanori Aizawa
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Takeshi Yamashita
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
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50
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Electrophysiological changes in laterodorsal tegmental neurons associated with prenatal nicotine exposure: implications for heightened susceptibility to addict to drugs of abuse. J Dev Orig Health Dis 2014; 6:182-200. [PMID: 25339425 DOI: 10.1017/s204017441400049x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Prenatal nicotine exposure (PNE) is a risk factor for developing an addiction to nicotine at a later stage in life. Understanding the neurobiological changes in reward related circuitry induced by exposure to nicotine prenatally is vital if we are to combat the heightened addiction liability in these vulnerable individuals. The laterodorsal tegmental nucleus (LDT), which is comprised of cholinergic, GABAergic and glutamatergic neurons, is importantly involved in reward mediation via demonstrated excitatory projections to dopamine-containing ventral tegmental neurons. PNE could lead to alterations in LDT neurons that would be expected to alter responses to later-life nicotine exposure. To examine this issue, we monitored nicotine-induced responses of LDT neurons in brain slices of PNE and drug naive mice using calcium imaging and whole-cell patch clamping. Nicotine was found to induce rises in calcium in a smaller proportion of LDT cells in PNE mice aged 7-15 days and smaller rises in calcium in PNE animals from postnatal ages 11-21 days when compared with age-matched control animals. While inward currents induced by nicotine were not found to be different, nicotine did induce larger amplitude excitatory postsynaptic currents in PNE animals in the oldest age group when compared with amplitudes induced in similar-aged control animals. Immunohistochemically identified cholinergic LDT cells from PNE animals exhibited slower spike rise and decay slopes, which likely contributed to the wider action potential observed. Further, PNE was associated with a more negative action potential afterhyperpolarization in cholinergic cells. Interestingly, the changes found in these parameters in animals exposed prenatally to nicotine were age related, in that they were not apparent in animals from the oldest age group examined. Taken together, our data suggest that PNE induces changes in cholinergic LDT cells that would be expected to alter cellular excitability. As the changes are age related, these PNE-associated alterations could contribute differentially across ontogeny to nicotine-mediated reward and may contribute to the particular susceptibility of in utero nicotine exposed individuals to addict to nicotine upon nicotine exposure in the juvenile period.
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