ACE inhibitors and myocardial remodeling in patients with arterial hypertension and atrial fibrillation
Abstract
The study is focused on assessing dynamics of left atrium volume and volume index after treatment of paroxysmal or persistent atrial fibrillation (AF), during ACE therapy with lipophilic (n=34) or hydrophilic (n=38) «standard» antihypertensive medications. After sinus rhythm restoration, mechanical dysfunction of left atrium was observed in 95, 8 % of the participants. Standard antihypertensive therapy, including lipophilic or hydrophilic ACE inhibitors, resulted in improved left atrium mechanical function and heart remodeling in 82, 1 %. Hydrophilic ACE inhibitor (Dapril) was no less effective than lipophilic medication (enalapril), being even more effective in terms of duration and dynamics of left atrium mechanical function recovery. Dapril demonstrated high effectiveness, no less than for enalapril, together with minimal adverse event rate (0 % vs 14 %>, respectively). This could improve patients' compliance to persistent medication therapy of the principal pathology.
About the Authors
O. N. Miller
Новосибирский государственный медицинский университет
Russian Federation
Russian Federation
O. N. Skurikhina
Новосибирский государственный медицинский университет
Russian Federation
Russian Federation
T. A. Gusyatnikova
Новосибирский государственный медицинский университет
Russian Federation
Russian Federation
G. E. Subrakov
Новосибирский государственный медицинский университет
Russian Federation
Russian Federation
References
1. Преображенский Д.В., Сидоренко Б.А. Медикаментозное лечение мерцания предсердий. М., 2003. С. 38-52
2. Aurigemma G.P., Gottdiener J.S., Shemanski L. et. al. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the cardiovascular health study//Am. Coll. Cardiol. 2001. Vol. 37(4). P. 1042-1048
3. Bustamante J.O., Rucnudin A., Sachs F. Stretch-activated channels in heart cells: relevance to cardiac hypertrophy//J. Cardiovasc. Pharmacol. 1991. Vol. 17(Suppl). P. S110-S113.
4. Cohen A., Chauvel C. The best of 2001. Echocardiography//Arch. Mai. Coeur. Vaiss. 2002. Vol. 95, N 1(5 Spec 1). P. 21-28
5. Duran N.E., Duran I., Sonmez K. et. al. Frequency and predictors of atrial fibrillation in severe mitral regurgitation//Anadolu. Kardiyol. Derg. 2003. Vol. 3(2). P. 129-134
6. Franz M.R., Cima R., Wang D. et. al. Electrophysiological effects of myocardial stretch and mechanical determinants of stretch-activated arrhythmia//Circulation. 1992. Vol. 86. P. 968-978
7. Levy S., Maarek M., Coumel P. et. al. Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study. The College of French Cardiologists//Circulation 1999 Jun 15; 99(23): 3028-3035
8. Levy S. Atrial fibrillation, the arrhythmia of the elderly, causes and associated conditions//Anadolu. Kardiyol. Derg. 2002. Vol. 2(l). P. 55-60
9. López-Gil M., Arribas F., Velázquez M.T., Casas P. Hypertensive cardiopathy and arrhythmias//Rev. Esp. Cardiol. 1997. Vol. 50 (Suppl). P. 68-73.
10. Rossi A., Enriquez-Sarano M., Burnett J.C. Jr. et. al. Natriuretic peptide levels in atrial fibrillation: a prospective hormonal and Doppler-echocardiographic study//J. Am. Coll. Cardiol. 2000. Vol. 5. P. 1256-1262
11. Sarubbi В., Ducceschi V., Santangelo L. et al. Arrhythmias in patients with mechanical ventricular dysfunction and myocardial stretch: role of mechano-electric feedback//Can. J. Cardiol. 1998. Vol. 14(2). P. 245-252
Review
For citations:
Miller O.N., Skurikhina O.N., Gusyatnikova T.A., Subrakov G.E. ACE inhibitors and myocardial remodeling in patients with arterial hypertension and atrial fibrillation. Russian Journal of Cardiology. 2007;(5):74-78. (In Russ.)
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