Antagonistas de los receptores de mineralocorticoides en Fibrilación Auricular, ¿Una nueva clase de fármacos antiarrítmicos?

Autores

DOI:

https://doi.org/10.20453/rmh.v35i2.5245

Palavras-chave:

Fibrilación auricular, antagonistas de los receptores de mineralocorticoides, aldosterona, sistema renina angiotensina aldosterona, insuficiencia cardiaca.

Resumo

Los ARM son beneficiosos en diversos estados patológicos. Se deben considerar a estos medicamentos como una nueva alternativa en el manejo de la FA, ya que los resultados en múltiples ensayos clínicos muestran su beneficio en la reducción de la aparición de la FA, y así poder validar la implementación de este medicamento en la práctica clínica diaria. Por este motivo el objetivo de esta revisión es dar a conocer la literatura que respalda a los ARM como un potencial fármaco antiarrítmico.

Biografia do Autor

Julio Aroom Onton Condorhuaman, Universidad Andina del Cusco. Cusco, Perú-Facultad de Medicina

         

Referências

Rico-Mesa JS, White A, Ahmadian-Tehrani A, Anderson AS. Mineralocorticoid Receptor Antagonists: a Comprehensive Review of Finerenone. Curr Cardiol Rep. 2020 Sep 10; 22(11):140. doi: 10.1007/s11886-020-01399-7.

Oraii A, Healey JS, Kowalik K, Pandey AK, Benz AP, Wong JA, et al. Mineralocorticoid receptor antagonists and atrial fibrillation: a meta-analysis of clinical trials. Eur Heart J. 2024 Mar 7; 45(10):756-774. doi:10.1093/eurheartj/ehad811

Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999 Sep 2; 341(10):709-17. doi: 10.1056/NEJM199909023411001.

Montalescot G, Pitt B, Lopez De Sa E, Hamm CW, Flather M, Verheugt F, et al. Early eplerenone treatment in patients with acute ST-elevation myocardial infarction without heart failure: the Randomized Double-Blind Reminder Study. Eur Heart J. 2014 Sep 7; 35(34):2295-302. doi: 10.1093/eurheartj/ehu164.

Václavík J, Sedlák R, Plachý M, Navrátil K, Plášek J, Jarkovský J, et al. Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension. 2011 Jun; 57(6):1069-75. doi: 10.1161/HYPERTENSIONAHA.111.169961.

McDonagh TA, Metra M, Adamo M, Baumbach A, Böhm M, Burri H, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21; 42(36):3599-3726. doi: 10.1093/eurheartj/ehab368.

Naccarelli G V., Filippone EJ, Foy A. Do Mineralocorticoid Receptor Antagonists Suppress Atrial Fibrillation/Flutter? J Am Coll Cardiol. 2021 Jul 13; 78(2):153-155. doi: 10.1016/j.jacc.2021.04.080.

Hindricks G, Potpara T, Kirchhof P, Kühne M, Ahlsson A, Balsam P, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021 Feb 1; 42(5):373-498. doi: 10.1093/eurheartj/ehaa612.

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019 Mar 5; 139(10):e56-e528. doi: 10.1161/CIR.0000000000000659.

Members WC, José A. Joglar MFFF, Mina K. Chung MFFF, Anastasia L. Armbruster PF, Emelia J. Benjamin MSFF, Janice Y. Chyou MFFF, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2024 Jan 2; 83(1):109-279. doi: 10.1016/j.jacc.2023.08.017

Tsuda K. Renin-Angiotensin System and Sympathetic Neurotransmitter Release in the Central Nervous System of Hypertension. Int J Hypertens. 2012; 2012:474870. doi: 10.1155/2012/474870.

Fountain JH, Kaur J, Lappin SL. Physiology, Renin Angiotensin System. StatPearls [Internet]. Last Update: March 12, 2023 [citado el 24 de enero de 2024]; Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK470410/

Butterworth MB. Regulation of the epithelial sodium channel (ENaC) by membrane trafficking. Biochim Biophys Acta. 2010 Dec; 1802(12):1166-77. doi: 10.1016/j.bbadis.2010.03.010.

Buffolo F, Tetti M, Mulatero P, Monticone S. Aldosterone as a Mediator of Cardiovascular Damage. Hypertension. 2022 Sep; 79(9):1899-1911. doi: 10.1161/HYPERTENSIONAHA.122.17964.

Reil JC, Hohl M, Selejan S, Lipp P, Drautz F, Kazakow A, et al. Aldosterone promotes atrial fibrillation. Eur Heart J. 2012 Aug; 33(16):2098-108. doi: 10.1093/eurheartj/ehr266.

Marks AR. Clinical implications of cardiac ryanodine receptor/calcium release channel mutations linked to sudden cardiac death. Circulation. 2002 Jul 2;106(1):8-10. doi: 10.1161/01.cir.0000021746.82888.83.17.

Gómez AM, Rueda A, Sainte-Marie Y, Pereira L, Zissimopoulos S, Zhu X, et al. Mineralocorticoid modulation of cardiac ryanodine receptor activity is associated with downregulation of FK506-binding proteins. Circulation. 2009 Apr 28; 119(16):2179-87. doi: 10.1161/CIRCULATIONAHA.108.805804.

Denham NC, Pearman CM, Caldwell JL, Madders GWP, Eisner DA, Trafford AW, et al. Calcium in the Pathophysiology of Atrial Fibrillation and Heart Failure. Front Physiol. 2018 Oct 4; 9:1380. doi: 10.3389/fphys.2018.01380.

Tsai CF, Yang SF, Chu HJ, Ueng KC. Cross-talk between mineralocorticoid receptor/angiotensin II type 1 receptor and mitogen-activated protein kinase pathways underlies aldosterone-induced atrial fibrotic responses in HL-1 cardiomyocytes. Int J Cardiol. 2013 Oct 25; 169(1):17-28. doi: 10.1016/j.ijcard.2013.06.046.

Santos RAS, Oudit GY, Verano-Braga T, Canta G, Steckelings UM, Bader M. Cardiovascular Neurohormonal Regulation: The renin-angiotensin system: going beyond the classical paradigms. Am J Physiol Heart Circ Physiol. 2019 May 1; 316(5):H958-H970. doi: 10.1152/ajpheart.00723.2018.

Kolkhof P, Bärfacker L. 30 YEARS OF THE MINERALOCORTICOID RECEPTOR: Mineralocorticoid receptor antagonists: 60 years of research and development. J Endocrinol. 2017 Jul; 234(1):T125-T140. doi: 10.1530/JOE-16-0600.

Rienstra M, Hobbelt AH, Alings M, Tijssen JGP, Smit MD, Brügemann J, et al. Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J. 2018 Aug 21; 39(32):2987-2996. doi: 10.1093/eurheartj/ehx739.

Nguyen BO, Crijns HJGM, Tijssen JGP, Geelhoed B, Hobbelt AH, Hemels MEW, et al. Long-term outcome of targeted therapy of underlying conditions in patients with early persistent atrial fibrillation and heart failure: data of the RACE 3 trial. EP Europace. 2022 Jul 15; 24(6):910-920. doi: 10.1093/europace/euab270

Kotecha D, Holmes J, Krum H, Altman DG, Manzano L, Cleland JGF, et al. Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis. Lancet. 2014 Dec 20; 384(9961):2235-43. doi: 10.1016/S0140-6736(14)61373-8.

Rienstra M, Damman K, Mulder BA, Van Gelder IC, McMurray JJV, Van Veldhuisen DJ. Beta-blockers and outcome in heart failure and atrial fibrillation: a meta-analysis. JACC Heart Fail. 2013 Feb; 1(1):21-8. doi: 10.1016/j.jchf.2012.09.002.

Mareev Y V., Shitov VN, Kiktev VG, Sapelnicov O V., Latipov RS, Grishin IR, et al. Cardiac resynchronization therapy in patients with permanent atrial fibrillation: results from the Resynchronization for Ambulatory Heart Failure Trial (RAFT). Circ Heart Fail. 2012 Sep 1; 5(5):566-70. doi: 10.1161/CIRCHEARTFAILURE.112.968867.

Disertori M, Latini R, Barlera S, Sci M, Franzosi MG, Staszewsky L, et al. Valsartan for Prevention of Recurrent Atrial Fibrillation. N Engl J Med. 2009 Apr 16; 360(16):1606-17. doi: 10.1056/NEJMoa0805710.

Swedberg K, Zannad F, McMurray JJV, Krum H, Van Veldhuisen DJ, Shi H, et al. Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure) study. J Am Coll Cardiol. 2012 May 1; 59(18):1598-603. doi: 10.1016/j.jacc.2011.11.063.

Cikes M, Claggett B, Shah AM, Desai AS, Lewis EF, Shah SJ, et al. Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction: The TOPCAT Trial. JACC Heart Fail. 2018 Aug; 6(8):689-697. doi: 10.1016/j.jchf.2018.05.005.

Liu T, Korantzopoulos P, Shao Q, Zhang Z, Letsas KP, Li G. Mineralocorticoid receptor antagonists and atrial fibrillation: a meta-analysis. Europace. 2016 May; 18(5):672-8. doi: 10.1093/europace/euv366.

Neefs J, van den Berg NWE, Limpens J, Berger WR, Boekholdt SM, Sanders P, et al. Aldosterone Pathway Blockade to Prevent Atrial Fibrillation: A Systematic Review and Meta-Analysis. Int J Cardiol. 2017 Mar 15; 231:155-161. doi: 10.1016/j.ijcard.2016.12.029.

Alexandre J, Dolladille C, Douesnel L, Font J, Dabrowski R, Shavit L, et al. Effects of Mineralocorticoid Receptor Antagonists on Atrial Fibrillation Occurrence: A Systematic Review, Meta-Analysis, and Meta-Regression to Identify Modifying Factors. J Am Heart Assoc. 2019 Nov 19; 8(22):e013267. doi: 10.1161/JAHA.119.013267.

Fatima K, Asad D, Shaikh N, Ansari SA, Kumar G, Rehman HA, et al. A Systematic Review and Meta-Analysis on Effectiveness of Mineralocorticoid Receptor Antagonists in Reducing the Risk of Atrial Fibrillation. Am J Cardiol. 2023 Jul 15; 199:85-91. doi: 10.1016/j.amjcard.2023.04.038.

Patoulias D, Papadopoulos C, Toumpourleka M, Doumas M. Meta-Analysis Addressing the Effect of Mineralcorticoid Receptor Antagonists on the Risk for New-Onset Atrial Fibrillation. Am J Cardiol. 2021 Oct 15; 157:150-152. doi: 10.1016/j.amjcard.2021.07.011

Publicado

2024-06-28

Como Citar

1.
Onton Condorhuaman JA. Antagonistas de los receptores de mineralocorticoides en Fibrilación Auricular, ¿Una nueva clase de fármacos antiarrítmicos?. Rev Méd Hered [Internet]. 28º de junho de 2024 [citado 2º de julho de 2024];35(2):103-10. Disponível em: https://revistas.upch.edu.pe/index.php/RMH/article/view/5245

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