Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy

Routine use of diuretics and neurohumoral activation make hypokalemia (serum K(+) < 3. 5 mM) a prevalent electrolyte disorder among heart failure patients, contributing to the increased risk of ventricular arrhythmias and sudden cardiac death in heart failure. Recent experimental studies have sug...

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Autores principales: Skogestad, Jonas, Aronsen, Jan Magnus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234658/
https://www.ncbi.nlm.nih.gov/pubmed/30464746
http://dx.doi.org/10.3389/fphys.2018.01500
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author Skogestad, Jonas
Aronsen, Jan Magnus
author_facet Skogestad, Jonas
Aronsen, Jan Magnus
author_sort Skogestad, Jonas
collection PubMed
description Routine use of diuretics and neurohumoral activation make hypokalemia (serum K(+) < 3. 5 mM) a prevalent electrolyte disorder among heart failure patients, contributing to the increased risk of ventricular arrhythmias and sudden cardiac death in heart failure. Recent experimental studies have suggested that hypokalemia-induced arrhythmias are initiated by the reduced activity of the Na(+)/K(+)-ATPase (NKA), subsequently leading to Ca(2+) overload, Ca(2+)/Calmodulin-dependent kinase II (CaMKII) activation, and development of afterdepolarizations. In this article, we review the current mechanistic evidence of hypokalemia-induced triggered arrhythmias and discuss how molecular changes in heart failure might lower the threshold for these arrhythmias. Finally, we discuss how recent insights into hypokalemia-induced arrhythmias could have potential implications for future antiarrhythmic treatment strategies.
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spelling pubmed-62346582018-11-21 Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy Skogestad, Jonas Aronsen, Jan Magnus Front Physiol Physiology Routine use of diuretics and neurohumoral activation make hypokalemia (serum K(+) < 3. 5 mM) a prevalent electrolyte disorder among heart failure patients, contributing to the increased risk of ventricular arrhythmias and sudden cardiac death in heart failure. Recent experimental studies have suggested that hypokalemia-induced arrhythmias are initiated by the reduced activity of the Na(+)/K(+)-ATPase (NKA), subsequently leading to Ca(2+) overload, Ca(2+)/Calmodulin-dependent kinase II (CaMKII) activation, and development of afterdepolarizations. In this article, we review the current mechanistic evidence of hypokalemia-induced triggered arrhythmias and discuss how molecular changes in heart failure might lower the threshold for these arrhythmias. Finally, we discuss how recent insights into hypokalemia-induced arrhythmias could have potential implications for future antiarrhythmic treatment strategies. Frontiers Media S.A. 2018-11-07 /pmc/articles/PMC6234658/ /pubmed/30464746 http://dx.doi.org/10.3389/fphys.2018.01500 Text en Copyright © 2018 Skogestad and Aronsen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Skogestad, Jonas
Aronsen, Jan Magnus
Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title_full Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title_fullStr Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title_full_unstemmed Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title_short Hypokalemia-Induced Arrhythmias and Heart Failure: New Insights and Implications for Therapy
title_sort hypokalemia-induced arrhythmias and heart failure: new insights and implications for therapy
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234658/
https://www.ncbi.nlm.nih.gov/pubmed/30464746
http://dx.doi.org/10.3389/fphys.2018.01500
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