Arrhythmogenic Marker for the Sudden Unexplained Death Syndrome in Thai Men

Nademanee, Koonlawee; Veerakul, Gumpanart; Nimmannit, S; Chaowakul, Vipada; Bhuripanyo, K; Likittanasombat, Khanchit; Tunsanga, Kriang; Kuasirikul, Surachai; Malasit, Prida; Tansupasawadikul, Sudarat; Tatsanavivat, Pyatat

doi:10.1161/01.cir.96.8.2595

Cited by 470 publications

(283 citation statements)

References 16 publications

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“…Sudden cardiac death is a major cause of death in many industrialized countries including Thailand (27,30). It is most often caused by a lethal cardiac arrhythmia known as ventricular fibrillation (VF) (27,(30)(31)(32)(33)(34)(35).…”

Section: Sildenafil Citrate and Sudden Cardiac Deathmentioning

confidence: 99%

Effect of sildenafil citrate on the cardiovascular system

Shinlapawittayatorn

Chattipakorn

2005

Braz J Med Biol Res

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Sildenafil citrate is a drug commonly used to manage erectile dysfunction. It is designated chemically as 1- [[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4 ethoxyphenyl] sulfonyl]-4-methylpiperazine citrate (C 22 H 30 N 6 O 4 S). It is a highly selective inhibitor of cyclic guanine monophosphate-specific phosphodiesterase type 5. In late March through mid-November 1998, the US Food and Drug Administration (FDA) published a report on 130 confirmed deaths among men (mean age, 64 years) who received prescriptions for sildenafil citrate, a period during which >6 million outpatient prescriptions (representing about 50 million tablets) were dispensed. The US FDA recently reported that significant cardiovascular events, including sudden cardiac death, have occurred in men with erectile dysfunction who were taking sildenafil citrate. These reports have raised concerns that sildenafil citrate may increase the risk of cardiovascular events, particularly fatal arrhythmias, in patients with cardiovascular disease. In the past few years, the cardiac electrophysiological effects of sildenafil citrate have been investigated extensively in both animal and clinical studies. According to extensive data available to date, sildenafil citrate has been shown to pose minimal cardiovascular risks to healthy people taking this drug. Some precautions are needed for patients with cardiovascular diseases. However, the only absolute contraindication for sildenafil citrate is the concurrent use of nitrates. This article is intended to review sildenafil citrate's cardiovascular effects, as well as current debates about its arrhythmogenic effects.

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Section: Sildenafil Citrate and Sudden Cardiac Deathmentioning

confidence: 99%

Effect of sildenafil citrate on the cardiovascular system

Shinlapawittayatorn

Chattipakorn

2005

Braz J Med Biol Res

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“…In male Thai patients with RBBB and ST-elevation, mean QT c was slightly longer than normal. 10 Families with (drug-induced) STsegment elevation and QT prolongation have also been described. 11,12 Conduction disorders vary from non-specific to specific for any given part of the conduction system (in drug-free state).…”

Section: Electrocardiographic Characteristicsmentioning

confidence: 99%

Proposed Diagnostic Criteria for the Brugada Syndrome

Wilde

Antzelevitch

Borggrefe

et al. 2002

European Heart Journal

308

124

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“…It is the main cause of death among young healthy men in Southeast Asia. 3 Recent reports suggest that BrS could be responsible for 4% of all SCD and up to 12% of sudden death in patients with structurally normal hearts. The clinical phenotype manifests in adulthood, at a mean age of 41 years, and it is 8-to 10-times more frequent in males.…”

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confidence: 99%

Brugada syndrome: clinical and genetic findings

Sarquella-Brugada

Campuzano

Arbelo

et al. 2016

Genetics in Medicine

126

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Review ARticleMore than 20 years ago, eight individuals were resuscitated from sudden cardiac death (SCD) caused by documented ventricular fibrillation (VF); all showed a characteristic ST segment elevation in the right precordial leads and a structurally normal heart. 1 In 1996, the term "Brugada syndrome" (BrS) was used to describe what was previously known as "right bundle branch block, persistent ST segment elevation, and sudden death syndrome. " 2 A year later, BrS was reported to be the same disease as sudden unexplained nocturnal death syndrome (SUNDS). In other countries, BrS has different names: Lai Tai (Thailand), Pokkuri (Japan), and Bangungut (Philippines). Currently, the prevalence of BrS is estimated at ~3-5 in 10,000 people, and it is higher in young men of Southeast Asian origin. It is the main cause of death among young healthy men in Southeast Asia. 3 Recent reports suggest that BrS could be responsible for 4% of all SCD and up to 12% of sudden death in patients with structurally normal hearts. The clinical phenotype manifests in adulthood, at a mean age of 41 years, and it is 8-to 10-times more frequent in males. Frequently, sudden death can be the first manifestation of the disease. 4 In 1998, the genetic basis of BrS was established when the sodium channel protein type V subunit α gene (SCN5A), which encodes the α-subunit of the voltage-gated Na v 1.5 cardiac sodium channel responsible for regulating rapid sodium current (I Na ), was associated with the disease. 5 Currently, BrS is recognized as a rare, inherited cardiac channelopathy caused by an alteration of ionic currents that leads to ventricular arrhythmias and SCD. It is clinically characterized by ST segment elevation in leads V1-V3 of the electrocardiogram, but incomplete penetrance and variable expressivity confound the diagnosis. 6 Despite the identification of 18 associated genes, 65-70% of clinically diagnosed cases remain without an identifiable genetic cause. 4 CLINICAL DIAGNOSIS Diagnostic criteriaThe clinical diagnosis of BrS requires the identification of the ST segment elevation in the right precordial leads at baseline or after the use of sodium blockers. Three different electrocardiographic (ECG) patterns can be often observed in families with BrS: type I, which consists of a coved-type ST segment elevation greater than 2 mm followed by a descending negative T wave in at least two right precordial leads (V1 to V3); type II ST elevation, saddleback-shaped patterns with a high initial increase followed by an ST elevation greater than 2 mm; and saddleback-shaped patterns with a high initial increase followed by an ST elevation less than 2 mm (Figure 1). The second Brugada Consensus Report proposed that only type I is diagnostic for BrS 7 and, in 2013, it was proposed that a definitive diagnosis of BrS considers both spontaneous type I pattern and a provoked type I pattern (with a baseline type II or III pattern) in at least one right precordial lead (V1 or V2). 8 The diagnosis of BrS is currently accepted in those patients ...

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Arrhythmogenic Marker for the Sudden Unexplained Death Syndrome in Thai Men

Abstract: Right bundle-branch block and precordial injury pattern in V1 through V3 is common in SUDS patients and represents an arrhythmogenic marker that identifies patients who face an inordinate risk of ventricular fibrillation or sudden death.

Cited by 470 publications

References 16 publications

Effect of sildenafil citrate on the cardiovascular system

Effect of sildenafil citrate on the cardiovascular system

Proposed Diagnostic Criteria for the Brugada Syndrome

Brugada syndrome: clinical and genetic findings

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