持续性房颤患者恢复窦性心律的作用:一项临床、超声心动图及激素研究  

Effects of sinus rhythm restoration in patients with persistent atrial fibrillation: A clinical, echocardiographic and hormonal study

作　　者：Wozakowska Kap on B. Opolski G. 王永兴 

机构地区：[1]Department of Cardiology, Regional District Hospital, Swietokrzyskie Ctr. Kardiologii, U., Kielce, Poland

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2005年第2期42-43,共2页

摘　　要：The hemodynamic consequences of atrial fibrillation (AF) may lead to impairme nt of the left ventricular function and a reduction in exercise capacity. Studie s on mechanical and neurohormonal remodelling in patients with AF are becoming i ncreasingly important. The results could possibly enhance treatment strategies o f these patients. The aim of this study was to assess changes in exercise capaci ty, echocardiographic findings and plasma atrial natriuretic peptide(ANP) concen trations in patients with non rheumatic persistent AF, before and 30 days after successful cardioversion. Methods: We attempted cardioversion in 42 consecutive patients, aged 58±8 years, with persistent non valvular AF of duration 7.1±7 .1 months. They underwent echocardiography examination and submaximal exercise t esting 24 h before and 30 days after cardioversion. Exercise capacity was determ ined during symptom limited exercise testing, according to a modified Bruce pro tocol with peak VO2 analysis. Plasma samples of ANP were obtained at rest: befor e, the day after, and 30 days after cardioversion therapy, and were prepared by refrigerated centrifugation and stored until radioimmunoassay. The control study group, without AF, comprised of 11 subjects. Results: Cardioversion was success ful in 35 patients. However, in six of the 35 patients, AF reappeared within 1 m onth. There were no statistical differences before cardioversion in exercise tol erance and ejection fraction of left ventricle between the group with successful cardioversion and the group with unsuccessful cardioversion or with recurrence of AF. On the 30th day after cardioversion we recorded a significant increase in exercise tolerance: duration of exercise 13.7±3.2 versus 9.5±3.4 min, (P< 0.0 5); peak oxygen consumption 32.2±3.6 versus 19.85±3.5 ml/min per kg, (P< 0.05) ; and ejection fraction of left ventricle 58.6±9.4 versus 52.7±10.2%(P< 0.05) ; in the sinus rhythm group. There was no significant improvement observed in th e AF group. The mean baseline ANP levThe hemodynamic consequences of atrial fibrillation (AF) may lead to impairme nt of the left ventricular function and a reduction in exercise capacity. Studie s on mechanical and neurohormonal remodelling in patients with AF are becoming i ncreasingly important. The results could possibly enhance treatment strategies o f these patients. The aim of this study was to assess changes in exercise capaci ty, echocardiographic findings and plasma atrial natriuretic peptide(ANP) concen trations in patients with non rheumatic persistent AF, before and 30 days after successful cardioversion. Methods: We attempted cardioversion in 42 consecutive patients, aged 58±8 years, with persistent non valvular AF of duration 7.1±7 .1 months. They underwent echocardiography examination and submaximal exercise t esting 24 h before and 30 days after cardioversion. Exercise capacity was determ ined during symptom limited exercise testing, according to a modified Bruce pro tocol with peak VO2 analysis. Plasma samples of ANP were obtained at rest: befor e, the day after, and 30 days after cardioversion therapy, and were prepared by refrigerated centrifugation and stored until radioimmunoassay. The control study group, without AF, comprised of 11 subjects. Results: Cardioversion was success ful in 35 patients. However, in six of the 35 patients, AF reappeared within 1 m onth. There were no statistical differences before cardioversion in exercise tol erance and ejection fraction of left ventricle between the group with successful cardioversion and the group with unsuccessful cardioversion or with recurrence of AF. On the 30th day after cardioversion we recorded a significant increase in exercise tolerance: duration of exercise 13.7±3.2 versus 9.5±3.4 min, (P< 0.0 5); peak oxygen consumption 32.2±3.6 versus 19.85±3.5 ml/min per kg, (P< 0.05) ; and ejection fraction of left ventricle 58.6±9.4 versus 52.7±10.2%(P< 0.05) ; in the sinus rhythm group. There was no significant improvement observed in th e AF group. The mean baseline ANP lev

关 键 词：持续性房颤 窦性心律 激素研究 复律 超声心动图 运动耐量 运动试验 射血分数 左室功能 心房利钠肽 

分 类 号：R541.7[医药卫生—心血管疾病]