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The Canadian Journal of Cardiology Apr 2022Ventricular arrhythmias and sudden cardiac death (SCD) occur most frequently in the setting of coronary artery disease, cardiomyopathy and heart failure but are also... (Review)
Review
Ventricular arrhythmias and sudden cardiac death (SCD) occur most frequently in the setting of coronary artery disease, cardiomyopathy and heart failure but are also increasingly observed in persons suffering from diabetes mellitus and obesity. The incidence of these metabolic disorders is rising in Western countries, but adequate prevention and treatment of arrhythmias and SCD in affected patients is limited because of our incomplete knowledge of the underlying disease mechanisms. Here, an overview is presented of the prevalence of electrophysiological disturbances, ventricular arrhythmias, and SCD in the clinical setting of diabetes and obesity. Experimental studies are reviewed, which have identified disease pathways and associated modulatory factors, in addition to pro-arrhythmic mechanisms. Key processes are discussed, including mitochondrial dysfunction, oxidative stress, cardiac structural derangements, abnormal cardiac conduction, ion channel dysfunction, prolonged repolarization, and dysregulation of intracellular sodium and calcium homeostasis. In addition, the recently identified pro-arrhythmic effects of dysregulated branched chain amino acid metabolism, a common feature in patients with metabolic disorders, are addressed. Finally, current management options are discussed in addition to the potential development of novel preventive and therapeutic strategies based on recent insight gained from translational studies.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Diabetes Mellitus; Humans; Obesity; Sodium
PubMed: 35017043
DOI: 10.1016/j.cjca.2022.01.001 -
Journal of the American College of... May 2021
Topics: Cardiopulmonary Resuscitation; Death, Sudden, Cardiac; Humans
PubMed: 33985680
DOI: 10.1016/j.jacc.2021.03.321 -
Nephrology, Dialysis, Transplantation :... Feb 2021Sudden cardiac death (SCD) represents a major cause of death in end-stage kidney disease (ESKD). The precise estimate of its incidence is difficult to establish because... (Review)
Review
Sudden cardiac death (SCD) represents a major cause of death in end-stage kidney disease (ESKD). The precise estimate of its incidence is difficult to establish because studies on the incidence of SCD in ESKD are often combined with those related to sudden cardiac arrest (SCA) occurring during a haemodialysis (HD) session. The aim of the European Dialysis Working Group of ERA-EDTA was to critically review the current literature examining the causes of extradialysis SCD and intradialysis SCA in ESKD patients and potential management strategies to reduce the incidence of such events. Extradialysis SCD and intradialysis SCA represent different clinical situations and should be kept distinct. Regarding the problem, numerically less relevant, of patients affected by intradialysis SCA, some modifiable risk factors have been identified, such as a low concentration of potassium and calcium in the dialysate, and some advantages linked to the presence of automated external defibrillators in dialysis units have been documented. The problem of extra-dialysis SCD is more complex. A reduced left ventricular ejection fraction associated with SCD is present only in a minority of cases occurring in HD patients. This is the proof that SCD occurring in ESKD has different characteristics compared with SCD occurring in patients with ischaemic heart disease and/or heart failure and not affected by ESKD. Recent evidence suggests that the fatal arrhythmia in this population may be due more frequently to bradyarrhythmias than to tachyarrhythmias. This fact may partly explain why several studies could not demonstrate an advantage of implantable cardioverter defibrillators in preventing SCD in ESKD patients. Electrolyte imbalances, frequently present in HD patients, could explain part of the arrhythmic phenomena, as suggested by the relationship between SCD and timing of the HD session. However, the high incidence of SCD in patients on peritoneal dialysis suggests that other risk factors due to cardiac comorbidities and uraemia per se may contribute to sudden mortality in ESKD patients.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Disease Management; Humans; Kidney Failure, Chronic; Renal Dialysis; Risk Factors
PubMed: 31538192
DOI: 10.1093/ndt/gfz182 -
Journal of the American College of... Feb 2016
Topics: China; Death, Sudden, Cardiac; Humans; Prevalence
PubMed: 26846954
DOI: 10.1016/j.jacc.2015.12.011 -
Journal of the American College of... Mar 2020
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Humans; Inflammation; Myocarditis
PubMed: 32138966
DOI: 10.1016/j.jacc.2020.01.032 -
Current Problems in Cardiology Jul 2023Mitral valve prolapse (MVP) affects about 2% to 3% of the general population, mostly women, and is the most common cause of primary chronic mitral regurgitation (MR) in... (Review)
Review
Mitral valve prolapse (MVP) affects about 2% to 3% of the general population, mostly women, and is the most common cause of primary chronic mitral regurgitation (MR) in western countries. The natural history is heterogeneous and widely determined by the severity of MR. Although most patients remain asymptomatic with a near-normal life expectancy, approximately 5% to 10 % progress to severe MR. As largely recognized, left ventricular (LV) dysfunction due to chronic volume overload per se identifies a subgroup at risk of cardiac death. However, there is rising evidence of a link between MVP and life threating ventricular arrhythmias (VAs)/sudden cardiac death (SCD) in a small subset of middle-aged patients without significant MR, heart failure and remodeled hearts. The present review focuses on the underlying mechanism of electric instability and unexpected cardiac death in this subset of young patients, from the myocardial scarring of the LV infero-lateral wall due to mechanical stretch exerted by the prolapsing leaflets and mitral annular disjunction, to the inflammation's impact on fibrosis pathways along with a constitutional hyperadrenergic state. The heterogeneity of clinical course reveals a necessity of risk stratification, preferably through noninvasive multimodality imaging, that will help to identify and prevent adverse scenarios in young MVP patients.
Topics: Middle Aged; Humans; Female; Male; Mitral Valve Prolapse; Death, Sudden, Cardiac; Arrhythmias, Cardiac; Mitral Valve Insufficiency; Mitral Valve; Heart Failure; Ventricular Dysfunction, Left
PubMed: 36967070
DOI: 10.1016/j.cpcardiol.2023.101724 -
European Journal of Heart Failure May 2020
Topics: Death, Sudden, Cardiac; Heart Failure; Humans; Myocardial Infarction
PubMed: 31975546
DOI: 10.1002/ejhf.1744 -
Systematic Reviews Mar 2024Sudden cardiac death (SCD) is a rare and yet unexplained condition. The most frequent cause is myocardial infarction, while a small proportion is due to arrhythmogenic... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Sudden cardiac death (SCD) is a rare and yet unexplained condition. The most frequent cause is myocardial infarction, while a small proportion is due to arrhythmogenic syndromes (e.g., channelopathies). This systematic review and meta-analysis aimed to provide a comprehensive overview of the prevalence and risk factors associated with SCD in workers.
MATERIAL AND METHODS
A search for eligible studies was performed utilizing three databases (PubMed, ISI Web of Knowledge, and Scopus). The inclusion criteria were fulfilled if sudden cardiac death due to channelopathy in workers was mentioned.
RESULTS
Out of the 1408 articles found across three databases, 6 articles were included in the systematic review but the meta-analysis was conducted on 3 studies The total sample included was 23,450 participants. The pooled prevalence of channelopathies in employees was 0.3% (95% CI 0.07-0.43%), of sudden cardiac death in employees was 2.8% (95% CI 0.37-5.20%), and of sudden cardiac death in employees with a diagnosis of cardiac channelopathies was 0.2% (95% CI 0.02- 0.30%).
CONCLUSIONS
SCD is a serious and potentially preventable condition that can occur among workers. By identifying and addressing work-related risk factors, providing appropriate screening and interventions, and promoting healthy lifestyle behaviors, we can work to reduce the incidence of SCD and improve the cardiovascular health and well-being of workers.
Topics: Humans; Channelopathies; Death, Sudden, Cardiac; Risk Factors; Myocardial Infarction; Incidence
PubMed: 38461297
DOI: 10.1186/s13643-024-02504-5 -
Medicina (Kaunas, Lithuania) Mar 2021Myocardial inflammation is an important cause of cardiovascular morbidity and sudden cardiac death in athletes. The relationship between sports practice and myocardial... (Review)
Review
Myocardial inflammation is an important cause of cardiovascular morbidity and sudden cardiac death in athletes. The relationship between sports practice and myocardial inflammation is complex, and recent data from studies concerning cardiac magnetic resonance imaging and endomyocardial biopsy have substantially added to our understanding of the challenges encountered in the comprehensive care of athletes with myocarditis or inflammatory cardiomyopathy (ICM). In this review, we provide an overview of the current knowledge on the epidemiology, pathophysiology, diagnosis, and treatment of myocarditis, ICM, and myopericarditis/perimyocarditis in athletes, with a special emphasis on arrhythmias, patient-tailored therapies, and sports eligibility issues.
Topics: Athletes; Death, Sudden, Cardiac; Humans; Inflammation; Myocarditis; Sports
PubMed: 33802881
DOI: 10.3390/medicina57030277 -
Indian Heart Journal 2020
Review
Topics: COVID-19; Cause of Death; Coronavirus Infections; Death, Sudden, Cardiac; Female; Humans; Incidence; India; Magnetic Resonance Imaging, Cine; Male; Pandemics; Pneumonia, Viral; Risk Assessment; Severe Acute Respiratory Syndrome
PubMed: 33189190
DOI: 10.1016/j.ihj.2020.10.001