1. Heart and bile acids - Clinical consequences of altered bile acid metabolism.
- Author
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Vasavan T, Ferraro E, Ibrahim E, Dixon P, Gorelik J, and Williamson C
- Subjects
- Apoptosis drug effects, Arrhythmias, Cardiac prevention & control, Bile Acids and Salts blood, Bile Acids and Salts chemistry, Cardiomyopathies blood, Cardiomyopathies epidemiology, Cardiomyopathies prevention & control, Cholagogues and Choleretics pharmacology, Cholagogues and Choleretics therapeutic use, Cholangitis blood, Cholangitis complications, Cholangitis drug therapy, Cholestasis, Intrahepatic blood, Cholestasis, Intrahepatic drug therapy, Cholestasis, Intrahepatic metabolism, Female, Heart drug effects, Heart physiopathology, Hemodynamics drug effects, Humans, Hydrophobic and Hydrophilic Interactions, Liver Cirrhosis, Biliary blood, Liver Cirrhosis, Biliary complications, Liver Cirrhosis, Biliary drug therapy, Maternal-Fetal Exchange, Myocytes, Cardiac pathology, Pregnancy, Pregnancy Complications blood, Pregnancy Complications drug therapy, Pregnancy Complications metabolism, Prevalence, Ursodeoxycholic Acid pharmacology, Ursodeoxycholic Acid therapeutic use, Arrhythmias, Cardiac etiology, Bile Acids and Salts metabolism, Cardiomyopathies etiology, Cholangitis metabolism, Cholestasis, Intrahepatic complications, Liver Cirrhosis, Biliary metabolism
- Abstract
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., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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