Long-Term and Transient Calcium Channel Blockers; A Systematic Review of Their Role in the Management of Cardiomyopathy in Transfusion-Dependent Thalassemia.

IF 1.2 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY
Ali Bazi, Alireza Khanahmad, Mohammad Hossein Khazaee-Nasirabadi, Mohammad Pirouzbakht, Kobra Ghorbani Biregani, Fatemeh Peymaninezhad, Roohollah Mirzaee Khalilabadi
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引用次数: 0

Abstract

Calcium channel blockers (CCBs) for long-term (L) and transient (T) calcium channels (LTCC and TTCC) on cardiomyocytes have been suggested to manage iron-induced cardiomyopathy in transfusion-dependent thalassemia patients. However, the results of clinical trials on the effectiveness of CCBs have been conflicting. Here, we systematically reviewed previous studies to investigate the potential factors that could act as therapeutic modifiers and explain these discrepancies. This systematic review was conducted employing the PRISMA guideline to retrieve clinical trials and animal studies investigating the efficacy of CCBs. Studies in the following databases were collected: Web of Science, PubMed, Scopus, Google Scholar, Clinical Trials, Iranian Registry for Clinical Trials, and Cochrane CENTRAL. Keywords included the trade and generic names of various CCBs, thalassemia, and cardiomyopathy. Our Primary search resulted in 297 studies, of which 21 (n = 7 trials and n = 14 animal studies) were further analyzed. The most important parameters that could potentially influence the clinical effectiveness of CCBs in managing iron-induced cardiomyopathy included baseline cardiac iron content, diversity of iron entry routes (LTCCs, TTCCs, DMT-1, etc.), type of CCBs used, iron-induced irreversible functional/structural cardiac changes, iron-Ca2+ joint metabolic dysregulation, deregulated expression of LTCCs and TTCCs, interaction of CCBs with iron chelators, disease-related complications, interactions of CCBs with various supplements used by patients, vitamin D and other nutrient deficiencies, and duration of treatment with CCBs. These items should be considered in future trials to draw more robust conclusions about the effectiveness of CCBs in preventing cardiac iron deposition and associated cardiomyopathy in TDT patients.

长期和短暂钙通道阻滞剂;它们在输血依赖型地中海贫血心肌病治疗中的作用的系统综述。
钙通道阻滞剂(CCBs)用于心肌细胞的长期(L)和短暂(T)钙通道(LTCC和TTCC)已被建议用于治疗输血依赖性地中海贫血患者铁诱导的心肌病。然而,关于CCBs有效性的临床试验结果一直存在矛盾。在此,我们系统地回顾了以往的研究,以探讨可能作为治疗调节剂的潜在因素并解释这些差异。本系统综述采用PRISMA指南检索调查CCBs疗效的临床试验和动物研究。收集了以下数据库中的研究:Web of Science、PubMed、Scopus、谷歌Scholar、Clinical Trials、Iranian Registry for Clinical Trials和Cochrane CENTRAL。关键词包括各种ccb的商品名和通用名、地中海贫血和心肌病。我们的初步检索结果为297项研究,其中21项(n = 7项试验和n = 14项动物研究)被进一步分析。可能影响CCBs治疗铁诱导心肌病临床有效性的最重要参数包括:基线心脏铁含量、铁进入途径的多样性(ltcc、ttcc、DMT-1等)、使用的CCBs类型、铁诱导的不可逆功能/结构心脏改变、铁- ca2 +关节代谢失调、ltcc和ttcc的表达失调、CCBs与铁螯合剂的相互作用、疾病相关并发症、CCBs与患者使用的各种补充剂的相互作用,维生素D和其他营养缺乏症,以及CCBs治疗的持续时间。这些项目应该在未来的试验中考虑,以得出关于CCBs在预防TDT患者心脏铁沉积和相关心肌病有效性的更有力的结论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hemoglobin
Hemoglobin 医学-生化与分子生物学
CiteScore
1.70
自引率
10.00%
发文量
59
审稿时长
3 months
期刊介绍: Hemoglobin is a journal in the English language for the communication of research and information concerning hemoglobin in humans and other species. Hemoglobin publishes articles, reviews, points of view The journal covers topics such as: structure, function, genetics and evolution of hemoglobins biochemical and biophysical properties of hemoglobin molecules characterization of hemoglobin disorders (variants and thalassemias), consequences and treatment of hemoglobin disorders epidemiology and prevention of hemoglobin disorders (neo-natal and adult screening) modulating factors methodology used for diagnosis of hemoglobin disorders
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