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首页> 外文期刊>Journal of cardiology >Relationship between efficacy of antiarrhythmic drug therapy and structural remodeling in patients with paroxysmal atrial fibrillation
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Relationship between efficacy of antiarrhythmic drug therapy and structural remodeling in patients with paroxysmal atrial fibrillation

机译：阵发性心房颤动患者抗心律失常药物治疗的疗效与结构重构的关系

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OBJECTIVES: To evaluate whether the response to antiarrhythmic drug therapy in patients with paroxysmal atrial fibrillation affects the development of structural remodeling in the left atrium and ventricle. METHODS: This study included 230 patients (158 men and 72 women, mean age 67 +/- 11 years) in whom antiarrhythmic drug therapy was attempted for > or = 12 months to maintain sinus rhythm (mean follow-up period 45 +/- 27 months). The patients were divided into three groups according to the response to antiarrhythmic drug therapy: group A consisted of 78 patients without recurrence of atrial fibrillation, group B consisted of 87 patients with recurrence of atrial fibrillation and electrical and/or pharmacological cardioversion to restore sinus rhythm, and group C consisted of 65 patients with permanent conversion despite antiarrhythmic drug therapy. RESULTS: In group A, left atrial dimension (LAD), left ventricular end-diastolic dimension (LVDd), and left ventricular ejection fraction (LVEF) did not change after antiarrhythmic drug therapy. In group B, LAD increased significantly after antiarrhythmic drug therapy (from 32.6 +/- 6.4 to 36.0 +/- 6.5 mm, p < 0.01), Whereas either LVDd or LVEF did not change after antiarrhythmic drug therapy. In group C, LAD increased significantly after antiarrhythmic drug therapy (from 37.3 +/- 7.0 to 40.5 +/- 7.9 mm, p < 0.01) and LVEF was significantly reduced after antiarrhythmic drug therapy (from 69.4 +/- 6.2% to 66.5 +/- 8.9%, p < 0.05). LVDd did not change after antiarrhythmic drug therapy. The plasma concentration of human atrial natriuretic peptide during sinus rhythm at the initiation of antiarrhythmic drug therapy in group A (30.5 +/- 26.7 pg/ml) was significantly lower than those in group B (48.0 +/- 49.7 pg/ml) and group C (49.7 +/- 39.5 pg/ml). CONCLUSIONS: The development of structural remodeling in human myocardium can be prevented with antiarrhythmic drug therapy if sinus rhythm is maintained without recurrence of atrial fibrillation in patients with paroxysmal atrial fibrillation.
机译：目的：评估阵发性房颤患者对抗心律失常药物治疗的反应是否影响左心房和心室结构重构的发展。方法：本研究包括230例患者（158例男性和72例女性，平均年龄67 +/- 11岁），他们尝试抗心律失常药物治疗≥12个月以维持窦性心律（平均随访期为45 +/-） 27个月）。根据对抗心律失常药物治疗的反应将患者分为三组：A组由78例无房颤复发的患者组成，B组由87例由房颤复发和电和/或药物心脏复律恢复窦性心律的患者组成。 ，C组由65例尽管有抗心律不齐药物治疗但仍永久转变的患者组成。结果：在A组中，抗心律失常药物治疗后左心房尺寸（LAD），左心室舒张末期尺寸（LVDd）和左心室射血分数（LVEF）未改变。在B组中，抗心律失常药物治疗后LAD显着增加（从32.6 +/- 6.4增至36.0 +/- 6.5 mm，p <0.01），而抗心律失常药物治疗后LVDd或LVEF均未改变。在C组中，抗心律不齐药物治疗后LAD显着增加（从37.3 +/- 7.0降至40.5 +/- 7.9 mm，p <0.01），抗心律不齐药物治疗后LVEF显着降低（从69.4 +/- 6.2％至66.5 + /-8.9％，p <0.05）。抗心律失常药物治疗后LVDd不变。 A组开始抗心律不齐药物治疗时窦性心律期间人心钠素的血浆浓度（30.5 +/- 26.7 pg / ml）明显低于B组（48.0 +/- 49.7 pg / ml），并且C组（49.7 +/- 39.5 pg / ml）。结论：如果维持阵发性心房颤动的窦性心律而无需再次发生房颤，则可以通过抗心律失常药物治疗来防止人心肌结构重构的发展。

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