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Effects of acute administration of iloprost on the cardiac autonomic nervous system and ventricular repolarisation in patients with systemic sclerosis
  1. F Guideri1,
  2. M Acampa2,
  3. S Rechichi1,
  4. P L Capecchi1,
  5. P E Lazzerini1,
  6. M Galeazzi3,
  7. A Auteri2,
  8. F Laghi-Pasini1
  1. 1Department of Clinical Medicine and Immunological Sciences, Section of Clinical Immunology, University of Siena, Italy
  2. 2Department of Clinical Medicine and Immunological Sciences, Section of Internal Medicine, University of Siena, Italy
  3. 3Department of Clinical Medicine and Immunological Sciences, Section of Rheumatology. University of Siena, Italy
  1. Correspondence to:
    Professor F Laghi-Pasini
    laghi{at}unisi.it

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Iloprost is a stable prostacyclin analogue effective in the treatment of Raynaud’s phenomenon (RP), associated with systemic sclerosis (SSc). Iloprost also has anti-arrhythmic effects,1–3 reputedly produced by direct and indirect activity on the cardiomyocyte electrophysiology. In particular, studies on animals suggest that the anti-arrhythmic properties of the drug may be indirectly produced by interference with the cardiac sympathetic reflexes.2,3

Indeed, it has been demonstrated that iloprost induces myocardial ischaemia in humans related to a “stealing” effect on coronaries,4 and prolongs the ventricular refractory period and the QT interval in animal hearts.5 Because prolongation of the QT interval is an established risk factor for life threatening arrhythmias in humans,6 these data seem to disagree with the anti-arrhythmic properties of the drug.

The present study aimed at determining whether the effect of iloprost on cardiac …

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