Chemical Cardiomyopathies: The Negative Effects of Medications and Nonprescribed Drugs on the Heart

Figueredo, Vincent M.

doi:10.1016/j.amjmed.2010.11.031

Cited by 66 publications

(45 citation statements)

References 44 publications

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“…Se han registrado muertes en pacientes que la utilizan como antimalárico, pero también en pacientes tratados por artritis reumatoide y lupus [6]. Una intoxicación aguda o crónica agudizada, puede resultar de extrema gravedad con fallo multiorgánico con necesidad de internar al paciente en Centro de Cuidado Intensivo.…”

Section: Introductionunclassified

Cardiomiopatías químicas: Repercusión funcional de la cloroquina en corazón aislado

Costa¹,

Torres²,

Hartmann³

et al. 2014

An Facultad Med

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ResumenLa cloroquina, es un fármaco utilizado en tratamiento y profilaxis de enfermedades producidas por plasmodios como malaria. También es usada en el tratamiento de algunas neoplasias, artritis reumatoide y lupus eritematoso crónico. La intoxicación por cloroquina puede resultar en cuadros clínicos de extrema gravedad, pudiendo ocasionar la muerte de los pacientes. Entre los órganos de impacto de toxicidad de la cloroquina se encuentra el corazón. Las características fisiopatológicas de las fallas cardíacas que origina la exposición aguda a cloroquina están pobremente caracterizadas.Este trabajo estudia los efectos de exposición aguda a cloroquina en corazón, identificando algunas funciones y moléculas afectadas en dicho órgano. Nuestros hallazgos indican que cloroquina produce inotropismo negativo (dosis de efecto medio, IC50 ~ 5 μM), siendo totalmente reversible a bajas dosis. Las cinéticas de promoción y de lavado del efecto, son sumamente rápidas (segundos). Cloroquina es también cronotrópica negativa y arritmogenética, con IC50 levemente mayor. Dosis superiores a 100 μM eliminan contracciones con persistencia de actividad eléctrica. Canales de Ca 2+ tipo L se bloquean a partir de estas concentraciones.Los resultados sugieren que la exposición extracelular aguda a cloroquina en el rango μM, en corazones aislados, afectan la función cardíaca contráctil y eléctrica, con diferente sensibilidad para ambas. El bloqueo a canales de Ca 2+ tipo L, sugiere que éstos pueden estar involucrados en el desacople excitocontráctil que produce la droga, mediante inhibición de la liberación de Ca 2+ inducida por Ca 2+, pudiendo relacionarse con su capacidad de producir cardiomiopatías químicas.Palabras Claves: Cloroquina, antimaláricos, corazón aislado, cardiomiopatías químicas, canales de Ca 2+ tipo L, calcio intracelular cardíaco.Title: Chemical cardiomyopathies: Functional consequences of the application of chloroquine to guineapig isolated hearts. AbstractChloroquine, is a drug used in the treatment and prophylaxis of plasmodium related diseases, such as malaria. It is also used in the treatment of rheumatoid arthritis, chronic lupus erythematosus or neoplasms. It has a toxic collateral effect and deaths have been reported in patients who have used it. One of the targets of CQ toxicity is the heart. The pathophysiological features of heart failure caused by acute exposure to chloroquine are poorly characterized.This paper characterizes the effects of acute exposure to chloroquine at the cardiac level, trying to understand how this drug may impair heart function. Our findings indicate that cholorquine has a negative inotropic effect (mean effect dose, IC50 ~ 5 μM), being reversible at low concentrations. The kinetics of promotion and wash-out are extremely fast (seconds). Chloroquine has also an arrhythmogenic and a

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Section: Introductionunclassified

Cardiomiopatías químicas: Repercusión funcional de la cloroquina en corazón aislado

Costa¹,

Torres²,

Hartmann³

et al. 2014

An Facultad Med

View full text Add to dashboard Cite

show abstract

“…Coronary artery spasm and pro-arrhythmic effects can account for acute events and death. Prolonged catecholamine excess with long-term ephedra use is one likely underlying mechanism for cardiomyopathy (Figueredo 2011). Importantly, ephedra is often co-abused with anabolic-androgenic steroids (Clark and Schofield 2005;Achar et al 2010).…”

Section: Ephedra (Ma Huang)mentioning

confidence: 99%

“…Acute and chronic cardiomyopathy from abuse is thought to be secondary to both direct cardiac toxicity and indirect amphetamine-induced hypertension, necrosis, and ischemia (Albertson et al 1999). The 3,4-methylenedioxymethamphetamine, commonly known as ecstasy, can cause myocardial infarction, arrhythmias, and cardiomyopathy (Mizia-Stec et al 2008;Figueredo 2011). Animal studies showed that repeated methamphetamine administration may directly induce cellular hypertrophy of cardiomyocytes, myocarditis with inflammatory infiltrates and areas of necrosis, and consequently, may cause eccentric left ventricular dilation and diastolic dysfunction, as well as contractile dysfunction in myocytes (Shenouda et al 2009).…”

Section: Amphetamines and Metamphetaminesmentioning

confidence: 99%

“…Several pathophysiologic mechanisms of action have been proposed how and why drugs affect the cardiac tissue. They vary depending on the inciting agent, including direct toxic effects, neurohormonal activation, altered calcium homeostasis, and oxidative stress (Figueredo 2011 (Figueredo 2011). …”

Section: Drugs Inducing Heart Failurementioning

confidence: 99%

“…Anabolicandrogenic steroids can cause hypertension, dyslipidemia, and impaired fasting glucose, as well as alterations in heart structure, including left ventricular hypertrophy and dilation, and impaired contraction and relaxation. Potential sequelae include hypertension, acute myocardial infarction, sudden cardiac death, abnormal cardiac repolarisation with QT interval prolongation, ventricular fibrillation triggered by exercise, atrial fibrillation, cardiac tamponade, development of dilative cardiomyopathy, and heart failure at a dose-dependent manner (Hausmann et al 1998;Stolt et al 1999;Du Toit et al 2005;Karila et al 2003;Figueredo 2011). Several case reports have linked adverse cardiac events and anabolic-androgenic steroids abuse in healthy young athletes (Stergiopoulos et al 2008;Ahlgrim and Guglin 2009).…”

mentioning

confidence: 99%

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Drug-Induced Cardiomyopathies

Klimas¹

2012

Cardiomyopathies - From Basic Research to Clinical Management

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Alcohol and cardiovascular disease in the geriatric population

Kalla

Figueredo

2017

Clinical Cardiology

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There has been little focus on the effects of alcohol on the elderly. Although the cardiovascular benefits of moderate alcohol consumption could be of the greatest benefit in this group, so might be the detrimental effects of abuse. In this article, we review available data on the effects of alcohol consumption on cardiovascular disease, cardiomyopathy, arrhythmias, hypertension, and vascular function in older adults. Alcohol consumption has increased in the US population age 65 years and older in the last decade, as has monthly heavy episodic drinking in older alcohol consumers. Studies of alcohol consumption in older subjects suggest that consumption in moderation does not increase the risk of heart failure, hypertension, or atrial arrhythmias, and may in fact improve vascular function and reduce cardiovascular disease events. As in younger subjects, heavy consumption, or abuse of alcohol, negates any potential protective cardiovascular effects, increasing the incidence of heart failure and hypertension. Although alcohol consumed in moderation does not appear harmful in the elderly population, heavier consumption exacerbates hypertension and increases the incidence of heart failure.

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Chemical Cardiomyopathies: The Negative Effects of Medications and Nonprescribed Drugs on the Heart

Cited by 66 publications

References 44 publications

Cardiomiopatías químicas: Repercusión funcional de la cloroquina en corazón aislado

Cardiomiopatías químicas: Repercusión funcional de la cloroquina en corazón aislado

Drug-Induced Cardiomyopathies

Alcohol and cardiovascular disease in the geriatric population

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