Does valproic acid cause cardiac arrhythmias, in particular QT-prolongations, as possible SUDEP risk factor?

Для выявления характера взаимосвязи спортивного анамнеза лиц, практиковавших в прошлом интенcивные физические нагрузки, и выявленных у них нарушений ритма сердца и внутрисердечной проводимости был проведен ретроспективный анализ медицинских документов 39 мужчинветеранов спорта (средний возраст - 61,6±11,3 года, средняя длительность постспортивного периода - 23,9±17,3 года, средний стаж соревновательной деятельности - 20,1±9,9 года), имеющих установленные сердечно-сосудистые заболевания. Проведено скрининговое обследование на предмет нарушений ритма и проводимости сердца, эхокардиографическое исследование. Выявлено, что распространенность устойчивых пароксизмов фибрилляции предсердий составила 42% в совокупной выборке, увеличиваясь с повышением уровня спортивной квалификации. Желудочковые нарушения ритма высокой градации выявлены у 14% обследованных. Лишь три параметра были достоверно связаны с риском нарушений ритма у ветеранов спорта: уровень спортивной квалификации, наличие генерализованного атеросклероза (антириск-фактор), возраст. Риск нарушений ритма у ветеранов спорта на 43% определяется указанными факторами. Был предложен алгоритм скрининга нарушений ритма у ветеранов спорта на основе клинических данных. Необходимы дальнейшие проспективные наблюдения для валидации алгоритма. In order to analyze the relationship between the athletic qualiﬁcation and syndrome of cardiac rhythm and conductivity disturbances in former athletes, a retrospective analysis of medical records of 39 male former athletes with cardiovascular complaints (mean age 61,6±11,3 years, mean duration of career in sports 23,9±17,3 years, mean duration of post-athletic period 20,1±9,9 years) was carried out. The patients were screened for cardiac arrhythmias and underwent echocardiography. The overall prevalence of sustained paroxysms of atrial ﬁbrillation was 42%, increasing with the athletic qualiﬁcation. Ryan grade 4 b -5 premature ventricular contractions were found in 14% of patients. 3 parameters were found to be the independent predictors of arrhythmias in former athletes, i. e. athletic qualiﬁcation, multifocal atherosclerosis (as an anti-risk factor), and age. The coefﬁcient of determinance for the created prognostic model reached 43%. Further prospective studies are needed to validate an algorithm.

Download Full-text

Superoxide dismutase 2 Val16Ala polymorphism is a risk factor for the valproic acid-related elevation of serum aminotransferases

Epilepsy Research ◽

10.1016/j.eplepsyres.2011.10.033 ◽

2012 ◽

Vol 99 (1-2) ◽

pp. 183-186 ◽

Cited By ~ 11

Author(s):

Junji Saruwatari ◽

Mariko Deguchi ◽

Yuki Yoshimori ◽

Madoka Noai ◽

Shiho Yoshida ◽

...

Keyword(s):

Valproic Acid ◽

Superoxide Dismutase ◽

Risk Factor ◽

Serum Aminotransferases ◽

Val16ala Polymorphism ◽

Superoxide Dismutase 2

Download Full-text

Nonalcoholic Fatty Liver Disease: An Emerging Driver of Cardiac Arrhythmia

Circulation Research ◽

10.1161/circresaha.121.319059 ◽

2021 ◽

Vol 128 (11) ◽

pp. 1747-1765

Author(s):

Ze Chen ◽

Jiayi Liu ◽

Feng Zhou ◽

Haomiao Li ◽

Xiao-Jing Zhang ◽

...

Keyword(s):

Risk Factor ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Cardiac Arrhythmias ◽

Fatty Liver Disease ◽

Cardiovascular Complications ◽

Cardiac Conduction ◽

Nonalcoholic Fatty Liver ◽

Emerging Risk

Cardiac arrhythmias and the resulting sudden cardiac death are significant cardiovascular complications that continue to impose a heavy burden on patients and society. An emerging body of evidence indicates that nonalcoholic fatty liver disease (NAFLD) is closely associated with the risk of cardiac arrhythmias, independent of other conventional cardiometabolic comorbidities. Although most studies focus on the relationship between NAFLD and atrial fibrillation, associations with ventricular arrhythmias and cardiac conduction defects have also been reported. Mechanistic investigations suggest that a number of NAFLD-related pathophysiological alterations may potentially elicit structural, electrical, and autonomic remodeling in the heart, contributing to arrhythmogenic substrates in the heart. NAFLD is now the most common liver and metabolic disease in the world. However, the upsurge in the prevalence of NAFLD as an emerging risk factor for cardiac arrhythmias has received little attention. In this review, we summarize the clinical evidence and putative pathophysiological mechanisms for the emerging roles of NAFLD in cardiac arrhythmias, with the purpose of highlighting the notion that NAFLD may serve as an independent risk factor and a potential driving force in the development and progression of cardiac arrhythmias.

Download Full-text

Metabolic syndrome and its association with psychotropic medications in psychiatric patients from CAISM–IGSS (Center for Comprehensive Care Mental Health/Guatemalan Institute of Social Security)

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2016 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S545-S546

Author(s):

J. Lopez

Keyword(s):

Metabolic Syndrome ◽

Valproic Acid ◽

Risk Factor ◽

Social Security ◽

Protective Factor ◽

Psychiatric Patients ◽

International Diabetes Federation ◽

Mood Stabilizers ◽

Competing Interest ◽

Glucose And Lipid Homeostasis

IntroductionThe use of antipsychotics represents an integral part of the psychiatric practice, unfortunately the use seems to be associated with an elevated frequency of metabolic alterations causing an important weight disorder and glucose and lipid homeostasis, diminishing life expectations for these patients, likely to develop metabolic syndrome without proper control.ObjectivesThis study intended to find the association between metabolic syndrome in patients with psychotropic treatments used in the Guatemalan Institute of Social Security (IGSS).MethodologyCohort Study (n = 43 patients) who were treated combined with antipsychotics and mood stabilizers or antidepressants, conducting checkups at the beginning, then two to four months after, evaluating diagnosis of metabolic syndrome according to the criteria stated by the International Diabetes Federation (IDF).ResultsRisk factor with the use of clozapine and valproic acid was revealed after four months of exposure (RR = 2.32). With the use of clozapine and mood stabilizers a risk factor was prevalent with exposure after four months (RR = 2.67), and with the use of antidepressants a protective factor for the development of metabolic syndrome was revealed at four months of exposure (RR = 0.3741).Conclusionsthe use of antipsychotics in combination with mood stabilizers represents a risk factor for developing metabolic syndrome, especially the association with valproic acid.Disclosure of interestThe author has not supplied his declaration of competing interest.

Download Full-text

Potassium disorders and cardiac arrhythmias

Drug and Therapeutics Bulletin ◽

10.1136/dtb.29.19.73 ◽

1991 ◽

Vol 29 (19) ◽

pp. 73-75

Keyword(s):

Risk Factor ◽

Cardiac Arrhythmia ◽

Cardiac Arrhythmias ◽

Independent Risk Factor ◽

Potassium Homeostasis ◽

Life Threatening

Severe disturbances of potassium homeostasis can cause life-threatening cardiac arrhythmias and need urgent treatment. ‘Dangerous’ hyperkalaemia is relatively easy to define; ‘dangerous’ hypokalaemia, less so. This article reviews evidence for hypokalaemia as an independent risk factor for serious cardiac arrhythmia, and discusses the management of hypo- and hyperkalaemia.

Download Full-text

Pharmacogenetics of valproic acid as unmodified risk factor of adverse drug reactions

Medical and Health Science Journal ◽

10.15208/mhsj.2011.129 ◽

2011 ◽

Vol 7 ◽

pp. 26-38 ◽

Cited By ~ 2

Author(s):

Natalia Shnayder ◽

Marina Pilugina ◽

Diana Dmitrenko ◽

Elena Bochanova ◽

Evgenia Shapovalova ◽

...

Keyword(s):

Valproic Acid ◽

Risk Factor ◽

Adverse Drug Reactions ◽

Drug Reactions

Download Full-text

The mistery of Gustave Flaubert's death: could sudden unexpected death in epilepsy be part of the context?

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000300038 ◽

2009 ◽

Vol 67 (2b) ◽

pp. 548-552 ◽

Cited By ~ 2

Author(s):

Marly de Albuquerque ◽

Carla A. Scorza ◽

Ricardo M. Arida ◽

Esper A. Cavalheiro ◽

Fulvio A. Scorza

Keyword(s):

Risk Factors ◽

Nervous System ◽

Risk Factor ◽

Cardiac Arrhythmias ◽

Gustave Flaubert ◽

Epileptic Activity ◽

Sudden Unexpected Death ◽

Unexpected Death ◽

Nervous Disease ◽

The Subject

Epilepsy is the most common serious neurological condition and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but high seizure frequency is a potential risk factor. Additionally, potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures or transmission of epileptic activity to the heart via the autonomic nervous system potentially play a role. More than two decades ago, temporal lobe epilepsy was suggested as having been the ''nervous disease'' of Gustave Flaubert, one of the most important French novelists. In these lines, as the circumstances of his death were the subject of fabulous and mysterious speculations, we postulated in this paper that Falubert' death could be due SUDEP phenomenon.

Download Full-text