Use of vitamins C and E as a prophylactic therapy to prevent postoperative atrial fibrillation.
Oxidative stress has been strongly involved in the underlying mechanism of atrial fibrillation, particularly in the arrhythmia occurring in patients undergoing cardiac surgery with extracorporeal circulation (postoperative atrial fibrillation). The ischemia/reperfusion injury thus occurring in the myocardial tissue contributes to the development of tissue remodeling, thought to be responsible for the functional heart impairment. Consequently, structural changes due to the cardiac tissue biomolecules attack by reactive oxygen and/or nitrogen species could account for functional changes in ion channels, transporters, membrane conductance, cytosolic transduction signals, and other events, all associated with the occurrence of arrhythmic consequences. The lack of success and significant side effects of anti-arrhythmic drugs have given rise to attempts aimed to develop alternative novel pharmacologic treatments. On this line, the biological properties of the antioxidant vitamins C and E suggest that they could decrease the vulnerability of the heart to the oxidative damage. Nevertheless, very few studies to assess their anti-arrhythmic effects have been reported in humans. The clinical and experimental evidence supporting the view that the pharmacological use of antioxidant vitamins could contribute to prevent postoperative atrial fibrillation is presented.
Rodrigo
Ramón
R
Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, University of Chile, Independencia 1027, Casilla 70058, Santiago 7, Chile. rrodrigo@med.uchile.cl
Vinay
José
J
Castillo
Rodrigo
R
Cereceda
Mauricio
M
Asenjo
René
R
Zamorano
Jaime
J
Araya
Julia
J
Castillo-Koch
Rodrigo
R
Espinoza
Juan
J
Larraín
Ernesto
E
D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D006801:Humans; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D018384:Oxidative Stress / Q000187:drug effects; D011183:Postoperative Complications / Q000517:prevention & control*; D014810:Vitamin E / Q000627:therapeutic use*
D000975:Antioxidants; D014810:Vitamin E; D001205:Ascorbic Acid