阻滞延迟钠电流:治疗心律失常的新曙光  

Inhibition of Late Sodium Current: A Novel Target to Treat Cardiac Arrhythmias

作　　者：卫晓红[1] 吴林[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《心血管病学进展》2013年第1期18-22,共5页Advances in Cardiovascular Diseases

基　　金：国家自然科学基金(81170156)

摘　　要：大量临床试验证明,目前应用的抗心律失常药物有很大局限性,可能使器质性心脏病患者心律失常病死率和总病死率增加,针对新的靶点寻找更加安全、有效的药物是抗心律失常药物研究的热点。选择性延迟钠电流阻滞剂在治疗浓度不抑制峰钠电流,不延长或仅有限度的延长动作电位时程或QT间期,可能避免药物致心律失常作用的危险,且对房性和室性心律失常均有效,因而针对抑制延迟钠电流的药物治疗可能是未来抗心律失常治疗的新方向。A large number of clinical trials indicate that the use of anti-arrhythmic drugs （ such as class Ⅰ and class Ⅲ ） is limited be- cause of the increased risk of arrhythmic mortality in patients with structural heart diseases and the all-cause mortality associated with the side effects of drugs. Therefore, developing safe and effective anti-arrhythmic drugs based on novel therapeutic targets is critical in cardiovascular research. Recent studies indicate that selective late sodium current inhibitors did not inhibit peak sodium current to slow the intra-ventricular conduction and caused no or limited APD/QT interval prolongation at the clinical relevant concentrations, hence is associated with no or low proarrhythmic activities, including the risk of polymorphic ventricular tachycardia. The results in basic and clinical studies indicate that late sodium current inhibitors are effective in both atrial and ventricular arrhythmias. Inhibition of late sodium current is a novel therapeutic strat- egy to treat cardiac arrhythmias in the future.

关 键 词：延迟钠电流 抗心律失常药 心律失常 动作电位时程 致心律失常作用 

分 类 号：R541.7[医药卫生—心血管疾病]