Atrial fibrillation in β‐thalassemia patients with a focus on the role of iron‐overload and oxidative stress: A review

Cardiac complications including arrhythmia and especially atrial fibrillation (AF) are common causes of death in β‐thalassemia patients. The main factor in the etiopathogenesis of these complications is iron overload, which results in increased oxidative stress. Although there is a known association...

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Veröffentlicht in:Journal of cellular physiology 2019-08, Vol.234 (8), p.12249-12266
Hauptverfasser: Nomani, Homa, Bayat, Golnaz, Sahebkar, Amirhossein, Fazelifar, Amir Farjam, Vakilian, Farveh, Jomezade, Vahid, Johnston, Thomas P., Mohammadpour, Amir Hooshang
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Sprache:eng
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Zusammenfassung:Cardiac complications including arrhythmia and especially atrial fibrillation (AF) are common causes of death in β‐thalassemia patients. The main factor in the etiopathogenesis of these complications is iron overload, which results in increased oxidative stress. Although there is a known association between cardiac complications and iron overload in β‐thalassemia patients, there is no comprehensive review on AF and excessive iron with a focus on oxidative stress in these patients. The aim of this article was to review the different aspects of AF in β‐thalassemia patients with a focus on the prevention and treatment of AF by using iron chelators and/or anti‐oxidants. AF in β‐thalassemia patients is more common than in the general population. One of the most important causes of AF is cardiac iron overload and the harmful effects of increased oxidative stress. Iron‐induced AF can be reversed by using an intensive iron chelation regimen. Based on a few experimental studies, the combination of iron chelators with some anti‐oxidants, including NAC, vitamin C, and acetaminophen, can lead to improved cardiac protection. However, the effect of such combinations on cardiac arrhythmias should be further evaluated with animal and human studies. In this article, the authors review studies evaluating the incidence rate of AF in β‐TM patients. Next, we focus on AF etiology and oxidative stress in patients with β‐TM, and finally, we discuss studies that have evaluated the effect of iron chelators on oxidative stress and arrhythmias, especially AF.
ISSN:0021-9541
1097-4652
DOI:10.1002/jcp.27968