A new therapeutic strategy for hypertrophic nonobstructive cardiomyopathy in humans. A randomized and prospective study with an Angiotensin II receptor blocker.
A new therapeutic strategy for hypertrophic nonobstructive cardiomyopathy in humans. A randomized and prospective study with an Angiotensin II receptor blocker.
复制标题
人类肥厚型非梗阻性心肌病的新治疗策略。
作者：
T. Yamazaki;J. Suzuki;R. Shimamoto;T. Tsuji;Yuki Ohmoto‐Sekine;K. Ohtomo;R. Nagai
本研究旨在观察血管紧张素II受体阻滞剂（ARB）对肥厚型非梗阻性心肌病（HNCM）心肌损害的改善作用。连续19例HNCM患者随机分为两组，然后在观察一年前后进行两次左心室质量（LVM）的电影磁共振评价。在ARB组中，在观察期间每天给予氯沙坦钾50 mg。采用盲法比较两组观察期后左心室质量与观察期前左心室质量的比值，从形态学角度评价ARB的改善作用。在ARB组中，治疗期前的左心室质量为203 +/- 47 cm（3），治疗期后为190 +/- 55 cm（3），最终左心室质量与初始左心室质量的比值为0.93 +/- 0.10。在非ARB组中，初始和最终左心室质量值分别为177 +/- 48 cm（3）和179 +/- 45 cm（3），最终左心室质量与初始左心室质量的比值为1.02 +/- 0.07。ARB组最终左心室质量与初始左心室质量的比值显著小于非ARB组（P = 0.03）。ARB组中较小的比率强烈表明，在一年的观察期内，ARB改善了HNCM的自然病程。因此，这是首次证明ARB在人HNCM中的疗效。
A randomized and prospective study was designed to prove the efficacy of angiotensin II receptor blockers (ARB) in the amelioration of myocardial impairment in hypertrophic nonobstructive cardiomyopathy (HNCM). Nineteen consecutive patients with HNCM were randomly assigned to two groups and then underwent cine magnetic resonance evaluation of left ventricular mass (LVM) twice just before and after one year of observation. In the ARB group, 50 mg of losartan potassium was administered once daily during the observation period. The ratio of LVM after the observation period over that before the period was blindly compared between the two groups to estimate morphologically the ameliorative effect of ARB. In the ARB group, LVM was 203 +/- 47 cm(3) before the treatment period and 190 +/- 55 cm(3) after the period and the ratio of the final LVM over the initial LVM was 0.93 +/- 0.10. In the non-ARB group the initial and final LVM values were 177 +/- 48 cm(3) and 179 +/- 45 cm(3), and the ratio of the final LVM over the initial LVM was 1.02 +/- 0.07. The ratio of the final LVM over the initial LVM in the ARB group was significantly smaller (P = 0.03) than that in the non-ARB group. The smaller ratio in the ARB group strongly indicates that ARB ameliorated the natural course of HNCM during the one year observation period. Thus, this is the first demonstration of the therapeutic efficacy of ARB in human HNCM.
DOI：
10.1016/s0735-1097(01)01509-1
发表时间：
2001-10-01
影响因子：
24
作者：
Lim, DS;Roberts, R;Marian, AJ
通讯作者：
Marian, AJ