Heart and bile acids - Clinical consequences of altered bile acid metabolism

BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR BASIS OF DISEASE

卷:1864

Article

Vasavan, Tharni¹  Ferraro, Elisa²  Ibrahim, Effendi^2,3  Dixon, Peter¹  Gorelik, Julia²  Williamson, Catherine¹ 

[1] Kings Coll London, Dept Women & Childrens Hlth, Guys Campus,Hodgkin Bldg, London SE1 1UL, England

[2] Imperial Coll London, Imperial Ctr Translat & Expt Med, Natl Heart & Lung Inst, Cane Rd, London W12 0NN, England

[3] Univ Teknol MARA, Fac Med, Sungai Buloh 40000, Malaysia

关键词: Bile acids;    Cirrhotic cardiomyopathy;    Intrahepatic cholestasis of pregnancy;    Primary biliary cholangitis;    Primary sclerosing cholangitis;    Ursodeoxycholic acid;   

DOI  :  10.1016/j.bbadis.2017.12.039

来源: Elsevier

【 摘 要 】

Cardiac dysfunction has an increased prevalence in diseases complicated by liver cirrhosis such as primary biliary cholangitis and primary sclerosing cholangitis. This observation has led to research into the association between abnormalities in bile acid metabolism and cardiac pathology. Approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy. Bile acids are directly implicated in this, causing QT interval prolongation, cardiac hypertrophy, cardiomyocyte apoptosis and abnormal haemodynamics of the heart. Elevated maternal serum bile acids in intrahepatic cholestasis of pregnancy, a disorder which causes an impaired feto-maternal bile acid gradient, have been associated with fatal fetal arrhythmias. The hydrophobicity of individual bile acids in the serum bile acid pool is of relevance, with relatively lipophilic bile acids having a more harmful effect on the heart. Ursodeoxycholic acid can reverse or protect against these detrimental cardiac effects of elevated bile acids.

【 授权许可】

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