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|本期目录/Table of Contents|

瑞舒伐他汀对扩张型心肌病心脏再同步化治疗后阵发性房颤的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第6期
页码:
680-682,686
栏目:
临床研究
出版日期:
2015-07-15

文章信息/Info

Title:
Effect of rosuvastatin on paroxysmal atrial fibrillation with dilated cardiomyopathy after cardiac resynchronization therapy
作者:
孙 辉; 陈谦谦; 徐勤成; 魏子秀; 田飞飞
(济宁市第一人民医院心脏中心，山东 济宁 272000)
Author(s):
SUN Hui;  CHEN Qian-qian;  XU Qin-cheng;  WEI Zi-xiu;  TIAN Fei-fei
(Department of Cardiology, Jining First People’s Hospital, Jining 272000, Shandong, China)
关键词:
心肌病; 扩张型; 心脏再同步化治疗; 心房颤动; 阵发性
Keywords:
Dilated cardiomyopathy;  cardiac resynchronization therapy;  atrial fibrillation
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的 观察瑞舒伐他汀对扩张型心肌病（dilated cardiomyopathy，DCM）患者心脏再同步化治疗（cardiac resynchronization therapy，CRT）后阵发性心房颤动（paroxysmal atrial fibrillation，PAF）的影响并探讨其机制。方法 入选我院DCM行CRT后患者44例，随机分为瑞舒伐他汀治疗组（试药组）和常规治疗组（对照组）各22例，所有患者试验前及18个月后检测低密度脂蛋白胆固醇(LDL-C)、脑钠尿肽(BNP)、超敏C反应蛋白(hs-CRP)水平并行超声心动图检查，跟踪分析起搏器中记录到的心房颤动事件。结果 两组患者在基线状态差异均无统计学意义。18个月后，共42人完成随访，与基线数据相比较，试验组hs-CRP、BNP、左房内径(LAD)、左室舒张末内径(LVEDD)均显著降低（P<0.05，P<0.01），对照组仅BNP、LVEDD显著降低（P<0.05），两组左室射血分数(LVEF)均显著升高（P<0.05),两组LDL-C均有所降低，但差异无统计学意义，试药组PAF发生率显著低于对照组〔10%(2/21) vs. 38%(8/21)，P<0.05〕。结论 瑞舒伐他汀可显著降低DCM患者CRT后PAF的发生率，其作用机制可能通过减轻炎症反应而非依赖降脂作用。
Abstract:
AIM To evaluate the effect of rosuvastatin on paroxysmal atrial fibrillation (PAF) in patients with dilated cardiomyopathy (DCM) after cardiac resynchronization therapy (CRT) and to explore its mechanism. METHODS Forty-four DCM patients who had undergone CRT were randomly divided into rosuvastatin group (22 patients) and control group (22 patients). Echocardiographic data, LDL-C, BNP and CRP were detected at the beginning of the study and 18 months after. Atrial fibrillations recorded by pacemakers were analyzed. RESULTS At baseline, no significant differences were found between groups (P>0.05). But 18 months after, CRP, BNP, LAD and LVEDD were significantly reduced in rosuvastatin group (P<0.05, P<0.01) and only BNP and LVEDD were reduced significantly in control group (P<0.05). LVEF increased significantly in both groups (P<0.05) and LDL-C reduced in both groups, but with no statistically significant difference (P>0.05). Ten of the 42 (23.8%) patients had new AF during follow up, with no statistically significant difference in rosuvastatin group (2/21, P>0.05), but with significant increase in the control group (8/21, P<0.05). CONCLUSION Rosuvastatin can reduce the risk of PAF in patients with DCM after cardiac resynchronization therapy possibly by the anti-inflammatory effects of rosuvastatin independently of its lipid-lowering role.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2014-09-12.
通讯作者：陈谦谦，主治医师，主要从事超声心动图诊疗研究 Email：qianqian-301@163.com
作者简介：孙辉，主治医师，硕士 Email：sunhui109@163.com
更新日期/Last Update: 2015-07-23