Bile acids induce arrhythmias: old metabolite, new tricks

Bile acids and cardiovascular function in cirrhosis

“…showed that taurocholic acid‐induced concentration‐dependent arrhythmia in human atrial myocardium and noted an association between atrial fibrillation and higher serum levels of nonursodeoxycholic bile acid conjugates and low levels of ursodeoxycholic acid conjugates in 250 patients. This reinforces the concept that bile acid composition and not only the increased concentration is important …”

“…This reinforces the concept that bile acid composition and not only the increased concentration is important. 66 The accumulating evidence of the bile acid alteration of cardiac function in cholestasis has led to the hypothesis that BAs may play a major role in the pathogenesis of cardiomyopathy in cholestatic liver diseases. 67 Based on evidence of their negative inotropic and chronotropic effects, Gazawi et al 68 showed that BAs also adversely affect cardiac β-adrenoceptor density and affinity and membrane fluidity, modifications which have also been described in cirrhotic cardiomyopathy.…”

Effect of cholic acid on fetal cardiac myocytes in intrahepatic choliestasis of pregnancy

“…Our previous studies verified that the unfavorable pregnancy outcome is related with the damage by CA to the fetal endothelial cells [8] . Recent studies indicated that CA exerts a toxic effect on the heart by directly damaging the cardiac ion channels [9] , thereby inducing malignant fetal arrhythmias, fetal stress and intrauterine deaths [1,10] . Ca 2+ is pivotal to cardiac contraction and to the signal transduction.…”

A Bitter Taste in Your Heart

“…Taurocholic acid Primary bile acid 4 300 (TC) Afterdepolarizations, atrial fibrillation, prolongation of contractile refractory period (Desai and Penny, 2013;Rainer et al, 2013) -300-1000…”