Effects of angiotensin II type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation
Effects of angiotensin II type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation
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DOI：
10.1016/s0735-1097(03)00464-9
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发表时间：
2003-06-18
影响因子：
24
通讯作者：
Saku, K
中科院分区：
文献类型：
--
作者：
Kumagai, K;Nakashima, H;Saku, K
目的 本研究的目的是评估血管紧张素 II 1 型受体 (AT1R) 拮抗剂对心房颤动 (AF) 慢性结构重构的影响。 背景 我们之前报道过 AT1R 拮抗剂坎地沙坦可预防快速起搏模型中的急性电重构。然而，坎地沙坦对 AF 慢性结构重塑的影响尚不清楚。 方法 通过右心房 (RA) 以 400 次/分钟快速起搏 5 周，诱导 20 只狗（对照组 10 只，坎地沙坦组 10 只）持续性 AF。坎地沙坦口服（10 mg/kg/天）一周，然后快速起搏，并持续五周。每周测量 AF 持续时间、RA 四个部位的心房有效不应期 (AERP) 以及从 RA 附件到其他三个部位的心房内传导时间 (CT)。 结果 五周后对照组的平均 AF 持续时间明显长于坎地沙坦组 (1,333 +/- 725 vs. 411 +/- 301 s，p < 0.01)。五周后 AERP 缩短程度在两组之间没有显着差异。使用坎地沙坦五周后，从 RA 附件到低 RA 的 CT 明显短于对照组（43 +/- 14 vs. 68 +/- 10 ms，p < 0.05）。坎地沙坦组的间质纤维化百分比显着低于对照组（RA 附件处为 7 +/- 2% 对比 16 +/- 1%，p < 0.001）。 结论 坎地沙坦可以通过抑制结构重塑的发展来预防 AF 的发展。 (J Am Coll Cardiol 2003；41:2197-204) (C) 2003 年，美国心脏病学会基金会。
OBJECTIVES The purpose of the present study was to evaluate the effect of angiotensin II type 1 receptor (AT1R) antagonist on chronic structural remodeling in atrial fibrillation (AF).BACKGROUND We previously reported that an AT1R antagonist, candesartan, prevents acute electrical remodeling in a rapid pacing model. However, the effect of candesartan on chronic structural remodeling in AF is unclear.METHODS Sustained AF was induced in 20 dogs (10 in a control group and 10 in a candesartan group) by rapid pacing of the right atrium (RA) at 400 beats/min for five weeks. Candesartan was administered orally (10 mg/kg/day) for one week before rapid pacing and was continued for five weeks. The AF duration, atrial effective refractory period (AERP) at four sites in the RA, and intra-atrial conduction time (CT) from the RA appendage to the other three sites were measured every week.RESULTS The mean AF duration in the control group after five weeks was significantly longer than that with candesartan (1,333 +/- 725 vs. 411 +/- 301 s, p < 0.01). The degree of AERP shortening after five weeks was not significantly different between the two groups. The CT from the RA appendage to the low RA after five weeks with candesartan was significantly shorter than that in the control (43 +/- 14 vs. 68 +/- 10 ms, p < 0.05). The candesartan group had a significantly lower percentage of interstitial fibrosis than the control group (7 +/- 2% vs. 16 +/- 1% at the RA appendage, p < 0.001).CONCLUSIONS Candesartan can prevent the promotion of AF by suppressing the development of structural remodeling. (J Am Coll Cardiol 2003;41:2197-204) (C) 2003 by the American College of Cardiology Foundation.