ATP-bağımlı potasyum kanal açıcıları ve blokerleri myokardiyal iskemi ve reperfüzyon sonrasi aritmik ya da antiaritmik etkileri

ATP-bağımlı potasyum kanalları miyokardial hücrelerde iskemi sırasında hücre içi ATP'nin azalmasına bağlı olarak açılan bir kanaldır. İskemiye bağlı olarak bu kanalların açılması ile hücre dışına çıkan potasyum, koroner ligasyonu takiben oluşan aritmilerin oluşmasında etkili bir faktördür. Bu nedenle bu kanalları bloke eden, selektif potasyum kanal blokerlerinin enfarktüs sonrası aritmileri ortadan kaldırabileceği düşünülmektedir. Ancak invitro ve invivo olarak son yıllarda yapılan bir çok çalışmada ATP-bağımlı potasyum kanal blokerlerinin (Glibenclamide) antiaritmik etkisinin yanında iskemiyi artırdığıda saptanmıştır. Bunun aksine potasyum kanal açıcıları ise iskemiyi azaltıcı etki gösterirken iskemi ve reperfüzyon sonrası aritmi şiddetini artırmaktadır. Bu konu tartışmalıdır ve daha fazla araştırmaya ihtiyaç vardır. Potasyum kanal blokerlerinin iskemiyi artırıcı etkisi olduğundan, istemiyi azaltıcı beta ya da alfa adrenerjik blokerlerle kombine olarak denenmesi gerektiği önerilmektedir. Bu yazıda, deneysel mikokardial iskemi ve reperfüzyon oluşturulması ile ilgili iteknikler anlatılmıştır. Bunu takiben, ATP-bağımlı potasyum kanal blokerleri ve açıcılarının miyokardiyal istemi ve reperfüzyonu sonrası aritmiler üzerine etkisi konusunda yapılan araştırmalar derlenmiş ve araştırma sonuçları tartışılmıştır.

Anahtar Kelimeler:

iskemi, aritmi, kalp hastalıkları, genel bakış

ATP-dependent potassium channel openers and blockers: proarhythmic or antiarrhythmic effects following myocardial ischemia and reperfusion

The ATP-dependent potassium channel is a channel that opens in response to decreased ATP in the cell during ischemia. Potassium released from the cell due to the ischemia, is a factor that is effective in producing the arrhythmias folloving coronary ligation. Tahat's why, the arrhythmias following infarction is thought to be able to abolished by the selective potassium channel blockers that block these channel. But it is shown that in several studies conducted in vivo and in vitro, the ATP-dependent potassium channel blocker (Glibenclamide) has pro-ischemic effects besides it's antiarrhythmic effects. On the other hand, the potassium channel openers decrease the ischemia but not the severity of arrhythmia generating in ischemia and reperfusion. This subject iş controversial and needs to be researched further. It is suggested that since the potassium channel blockers have ischemia increasing effect, it should be examined in combination with alpha or beta adrenergic blockers. In this article, the techniques to produce experimental myocardial ischemia and reperfusions are described. Then, the results of the studies related with the effect of ATP-depentdent potasssium channel blockers and openers on the arrhythmias in myocardial ischemia and reperfusions have reviewed and discussed.

Keywords:

ischaemia, arrhythmia, heart diseases, reviews,

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