Arrhythmogenic foods – A growing medical problem

Woosley, Raymond L.

doi:10.1016/j.tcm.2019.08.007

Cited by 16 publications

(10 citation statements)

References 38 publications

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Section: Resultsmentioning

confidence: 99%

“…Reports of arrhythmias such as Torsades de Pointes (TdP), and/or sudden death, along with small studies on normal subjects, have suggested that ingredients in Edks could have direct arrhythmogenic actions in patients with congenital LQTs (cLQTs). 14 In some cLQTs patients, it has been shown that Edks can prolong the QTc interval up to or more than 500 msec, the threshold of immediate danger. 14 These reports raise numerous clinically important questions, such as which other patients may be at risk of arrhythmias.…”

Section: Long Qt and Brugada Syndromementioning

confidence: 99%

“…14 In some cLQTs patients, it has been shown that Edks can prolong the QTc interval up to or more than 500 msec, the threshold of immediate danger. 14 These reports raise numerous clinically important questions, such as which other patients may be at risk of arrhythmias. For example, patients with coexistence of multiple clinical risk factors for TdP (e.g.…”

Section: Long Qt and Brugada Syndromementioning

confidence: 99%

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Energy drinks: a narrative review of their physiological and pathological effects

Piccioni

Covino

Zanza

et al. 2021

Internal Medicine Journal

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The consumption of energy drinks (Edks) has increased significantly in past years, with a growing market that is estimated to reach $61 billion by 2021 worldwide. Several studies demonstrated the physiological and pathological effects of these substances contained in Edks. The most common ingredient contained in Edks is caffeine, which is commonly mixed with taurine, and B-group vitamins. Scientific evidence of potentially serious adverse health effects are known, but it would be better to acquire more information regarding these beverages. We systematically checked Medical literature on MEDLINE-Pubmed from inception to January 2020 to find studies and reports on Edks and adverse events. Edks consumption is specially related to cardiovascular effects as malignant arrhythmias. We found a significant focus on arrhythmogenic risk in patients affected by long QT syndrome or other predisposing conditions for QT elongation. Other pathological effects are known as gastrointestinal, vascular and neurological disorders. Edks, as well as all caffeinated beverages, should be taken with caution or avoided in select populations, such as patients suffering from cardiovascular or neurological illnesses; their use can unmask a sleepy life-threatening disease. MethodsWe checked the medical literature on MEDLINE-Pubmed from inception to January 2020. The search strings were:

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Section: Resultsmentioning

confidence: 99%

Section: Long Qt and Brugada Syndromementioning

confidence: 99%

Section: Long Qt and Brugada Syndromementioning

confidence: 99%

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Energy drinks: a narrative review of their physiological and pathological effects

Piccioni

Covino

Zanza

et al. 2021

Internal Medicine Journal

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“…Taking certain medication or carrying inheritable mutations in genes encoding cardiac ion channels are not the sole circumstances that can lead to prolongation of the QT segment on the ECG. As recently emphasized in the concept of "arrhythmogenic foods", components of common diet can also affect this important cardio-safety metric (Tisdale, 2019;Woosley, 2020). Grapefruit-based beverages are probably the most emblematic example in this regard.…”

Section: Introductionmentioning

confidence: 99%

The Grapefruit Flavonoid Naringenin Inhibits Multiple Cardiac Ion Channels

Sanson

Boukaiba

Houtmann

et al. 2022

Preprint

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Drinking fresh grapefruit juice is associated with a significant prolongation of the QT segment on the electrocardiogram (ECG) in healthy volunteers. Among the prominent flavonoids contained in citrus fruits, the flavanone naringenin is known to be a blocker of the human ether-a-go-go related gene (hERG) potassium channel. We hypothesized that naringenin could interfere with other major ion channels shaping the cardiac ventricular action potential (AP). To this end, we examined the effects of naringenin on the seven currents comprising the Comprehensive in vitro Pro-Arrhythmia (CiPA) panel for early arrhythmogenic risk assessment in drug discovery and development. We used automated patch-clamp of human ion channels heterologously expressed in mammalian cell lines to evaluate half-maximal inhibitory concentrations (IC50). Naringenin blocked all CiPA currents tested with IC50 values in the 30 µM – 100 µM concentration-range. The rank-order of channel sensitivity was the following: hERG > Kir2.1 > NaV1.5 late > NaV1.5 peak > KV7.1 > KV4.3 > CaV1.2. This multichannel inhibitory profile of naringenin suggests exercising caution when large amounts of grapefruit juice or other citrus juices enriched in this flavanone are drunk in conjunction with QT prolonging drugs or by carriers of congenital long QT syndromes.

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“…Although wide, this list of “conventional” risk factors is not able to account for all cases of LQTS/TdP occurrence (and recurrence) in the clinical practice ( 4 ) and for this reason in the recent years, intensive investigations were undertaken to identify previously unrecognized risk factors. As a result, an increasing number of novel, “non-conventional” QT-prolonging risk factors for acquired LQTS have been recently recognized, including human immunodeficiency virus infection ( 14 ), male hypogonadism ( 15 , 16 ), heart failure with preserved ejection fraction ( 17 ), QT-prolonging foods ( 18 ), inflammation and autoimmunity ( 19 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

et al. 2021

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Autoimmunity is increasingly recognized as a novel pathogenic mechanism for cardiac arrhythmias. Several arrhythmogenic autoantibodies have been identified, cross-reacting with different types of surface proteins critically involved in the cardiomyocyte electrophysiology, primarily ion channels (autoimmune cardiac channelopathies). Specifically, some of these autoantibodies can prolong the action potential duration leading to acquired long-QT syndrome (LQTS), a condition known to increase the risk of life-threatening ventricular arrhythmias, particularly Torsades de Pointes (TdP). The most investigated form of autoimmune LQTS is associated with the presence of circulating anti-Ro/SSA-antibodies, frequently found in patients with autoimmune diseases (AD), but also in a significant proportion of apparently healthy subjects of the general population. Accumulating evidence indicates that anti-Ro/SSA-antibodies can markedly delay the ventricular repolarization via a direct inhibitory cross-reaction with the extracellular pore region of the human-ether-a-go-go-related (hERG) potassium channel, resulting in a higher propensity for anti-Ro/SSA-positive subjects to develop LQTS and ventricular arrhythmias/TdP. Recent population data demonstrate that the risk of LQTS in subjects with circulating anti-Ro/SSA antibodies is significantly increased independent of a history of overt AD, intriguingly suggesting that these autoantibodies may silently contribute to a number of cases of ventricular arrhythmias and cardiac arrest in the general population. In this review, we highlight the current knowledge in this topic providing complementary basic, clinical and population health perspectives.

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Arrhythmogenic foods – A growing medical problem

Cited by 16 publications

References 38 publications

Energy drinks: a narrative review of their physiological and pathological effects

Energy drinks: a narrative review of their physiological and pathological effects

The Grapefruit Flavonoid Naringenin Inhibits Multiple Cardiac Ion Channels

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

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