3 research outputs found
<i>CASQ2</i>: clinical and genetic insights into catecholaminergic polymorphic ventricular tachycardia across three families
Catecholaminergic polymorphic ventricular tachycardia is a primary channelopathy with a high mortality rate if left untreated. In 3 to 5% of catecholaminergic polymorphic ventricular tachycardia patients, mutations in the CASQ2 gene, either in a homozygous or compound heterozygous form, have been identified. In this article, we present a clinical case series of patients from three unrelated families with mutations in the CASQ2 gene, including three novel mutations (p.Leu167Pro, p.Asp325GlyfsTer7, and p.Glu259Ter). All our patients with homozygous or compound heterozygous CASQ2 gene mutations experienced a severe disease course, with early manifestations and resistance to specific anti-arrhythmic treatment, including beta-blockers. They exhibited a wide range of heart rhythm abnormalities, both ventricular and supraventricular, and had a high risk of sudden cardiac death. In all cases, ventricular heart arrhythmias persisted despite regular treatment with specific anti-arrhythmic agents, unless selective left-sided sympathectomy had been performed. The management of this patient group emphasized an individualized approach, combining medical and surgical treatment methods tailored to each patient's unique needs and condition
ΠΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½ Π² ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΠΈ: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ
Carbamazepine is a drug thatΒ hasΒ been usedΒ for a long time to treatΒ various neurological andΒ psychiatric disorders. The drug has effect onΒ manyΒ bodyΒ systems and,Β in particular, onΒ theΒ cardiovascular. The cardiovascular effect of carbamazepine depends on several factorsΒ suchΒ as theΒ presence/absence of any comorbidities and its plasma concentration. The drugβs antiarrhythmic effect was demonstrated previously in a number of experimental and clinical studies. In this article, we would like to present the clinical case of pediatric patient with frequent ventricular extrasystoles and arrhythmogenic myocardial dysfunction. Several antiarrhythmic drugs wereΒ ineffective in this patient, while carbamazepine administration contributed to theΒ decrease in ectopic activity up to minimal values.ΠΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ, ΠΊΠΎΡΠΎΡΡΠΉ Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ Π΄Π°Π²Π½ΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΡΡΡ Ρ ΡΠ΅Π»ΡΡΒ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Β ΠΈ ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Β ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ². ΠΡΠ΅ΠΏΠ°ΡΠ°Ρ ΡΠΏΠΎΡΠΎΠ±Π΅Π½ ΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ Π½Π° ΠΌΠ½ΠΎΠ³ΠΈΠ΅Β ΡΠΈΡΡΠ΅ΠΌΡ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ Π½Π° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ. ΠΠ΅ΠΉΡΡΠ²ΠΈΠ΅ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° Π½Π° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ ΡΡΠ΄Π° ΡΠ°ΠΊΡΠΎΡΠΎΠ², Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅Β ΠΎΡ Π½Π°Π»ΠΈΡΠΈΡΒ ΠΈΠ»ΠΈΒ ΠΎΡΡΡΡΡΡΠ²ΠΈΡ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠ΅ΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π² ΠΏΠ»Π°Π·ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΈ.Β Π Π°Π½Π΅Π΅Β Π² ΡΡΠ΄Π΅Β ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°Π±ΠΎΡ Π±ΡΠ»ΠΎ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°. Π Π΄Π°Π½Π½ΠΎΠΉΒ ΡΠ°Π±ΠΎΡΠ΅ ΠΌΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΈΠΌΠ΅Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ ΡΠ°ΡΡΠΎΠΉ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΠ΅ΠΉ ΠΈ Π°ΡΠΈΡΠΌΠΎΠ³Π΅Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠ΅ΠΉ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°, Ρ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΠΌΠΈ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈΒ Π±ΡΠ»Π°Β Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ,Β ΠΏΡΠΈΒ ΡΡΠΎΠΌ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°Π»ΠΎΒ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΠΎΡΡΠΈ ΡΠΊΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π΄ΠΎ ΠΌΠΈΠ½ΠΈΠΌΠ°Π»ΡΠ½ΡΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° Π½Π° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌΡ: ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
Carbamazepine is an anticonvulsant that is commonly used in neurological and psychiatric patients to treat epileptic seizures, neuropathic pain, or bipolar disorder. Carbamazepine side effects, as well as side effects of many antiepileptic drugs, include cardiotoxic effects such as atrioventricular block, bradycardia, and cardiac rhythm disorders. However, carbamazepine has also been reported to have antiarrhythmic, normotimic, and membrane-stabilizing effects. This results in its administration to treat arrhythmias in children. Based on literature, carbamazepine administration as anti-arrhythmic drug is known in cases where the basic therapy was ineffective. The medication is not registered anywhere in the world for this purpose. Thus, it can be administered only off-label. The aim of our literature review is to analyze and summarize the existing data on carbamazepine effects on cardiovascular system, to determine its safety as anti-arrhythmic drug, and to describe various factors fostering its side effects.ΠΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΡΠ΄ΠΎΡΠΎΠΆΠ½ΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ, ΠΊΠΎΡΠΎΡΡΠΉ Π½Π΅ΡΠ΅Π΄ΠΊΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΡΡΡ Ρ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅Π»ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠΏΠΈΠ»Π΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΡΡΡΠΏΠΎΠ², Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»ΠΈ ΠΈΠ»ΠΈ Π±ΠΈΠΏΠΎΠ»ΡΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π°. ΠΠΎΠ±ΠΎΡΠ½ΡΠ΅ ΡΠ²Π»Π΅Π½ΠΈΡ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π°, ΡΠ°ΠΊ ΠΆΠ΅ ΠΊΠ°ΠΊ ΠΈ ΠΏΠΎΠ±ΠΎΡΠ½ΡΠ΅ ΡΠ²Π»Π΅Π½ΠΈΡ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠΏΠΈΠ»Π΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ΅Π΄ΡΡΠ², Π²ΠΊΠ»ΡΡΠ°ΡΡ Π² ΡΠ΅Π±Ρ ΠΊΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΡ, ΡΠ°ΠΊΠΈΠ΅ ΠΊΠ°ΠΊ Π°ΡΡΠΈΠΎΠ²Π΅Π½ΡΡΠΈΠΊΡΠ»ΡΡΠ½Π°Ρ Π±Π»ΠΎΠΊΠ°Π΄Π°, Π±ΡΠ°Π΄ΠΈΠΊΠ°ΡΠ΄ΠΈΡ ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΠΌΠ° ΡΠ΅ΡΠ΄ΡΠ°. Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅, Ρ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎΠΏΠΈΡΠ°Π½ΠΎ Π½Π°Π»ΠΈΡΠΈΠ΅ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ, Π½ΠΎΡΠΌΠΎΡΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½ΠΎΡΡΠ°Π±ΠΈΠ»ΠΈΠ·ΠΈΡΡΡΡΠ΅Π³ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ, ΡΡΠΎ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»ΠΈΠ²Π°Π΅Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Ρ ΡΠ΅Π»ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΌΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ. ΠΠΎ Π΄Π°Π½Π½ΡΠΌ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π² ΡΠ΅Ρ
ΡΠ»ΡΡΠ°ΡΡ
, ΠΊΠΎΠ³Π΄Π° Π±Π°Π·ΠΈΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ. ΠΠΎ ΡΡΠΎΠΌΡ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ Π½Π΅ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½ Π½ΠΈΠ³Π΄Π΅ Π² ΠΌΠΈΡΠ΅, ΠΈ, ΡΠ°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΠΎΠ½ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΡΡΡ Π²Π½Π΅ ΠΎΡΠΈΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΈΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ. Π¦Π΅Π»ΡΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±Π·ΠΎΡΠ° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΡΠ²Π»ΡΠ΅ΡΡΡ Π°Π½Π°Π»ΠΈΠ· ΠΈ ΠΎΠ±ΠΎΠ±ΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΡ
Π΄Π°Π½Π½ΡΡ
ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΠΈ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° Π½Π° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠ°ΡΠ±Π°ΠΌΠ°Π·Π΅ΠΏΠΈΠ½Π° Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π°Π½ΡΠΈΠ°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΡΡΠΈΡ
ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΅Π³ΠΎ ΠΏΠΎΠ±ΠΎΡΠ½ΡΡ
ΡΠ²Π»Π΅Π½ΠΈΠΉ