当前位置:循环首页>正文

[ESH2010]高血压合并心衰患者房颤治疗进展——M. Schneider教授专访

作者:  M.Schneider   日期:2010/6/20 17:08:00

国际循环网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

< International Circulation>: You had a wonderful and interesting presentation. RAS activation is one of the most important mechanisms hypertension and is also related to the incidence of atrial fibrillation. What do you think about the effects of ACE inhibitors and ARBs for the treatment and prevention of atrial fibrillation?

    < International Circulation>:  You had a wonderful and interesting presentation.  RAS activation is one of the most important mechanisms hypertension and is also related to the incidence of atrial fibrillation. What do you think about the effects of ACE inhibitors and ARBs for the treatment and prevention of atrial fibrillation?

    Prof. Schneider:  We have found in our meta-analysis that using either an ACE inhibitor or an angiotensin receptor blocker can prevent the development of atrial fibrillation by 33%.  This is when you take all of the studies that have been published together.  This means looking at both primary prevention, the new onset of atrial fibrillation, and also secondary prevention, meaning the recurrence of atrial fibrillation.  In the primary prevention group we have three categories; patients who had hypertension, paitents who had myocardial infarction, and patients who had heart failure.  In the secondary prevention trials we had a group of patients who had had cardioversion for mostly permanent atrial fibrillation and we had a group who had had medical therapy for paroxysmal atrial fibrillation.  Overall there was a reduction in atrial fibrillation by 33%, but there was substantial heterogeneity between trials meaning that the effects comparing individual trials was very inconsistent and that is why we have compared trials more closely in these subgroups.  In hypertension overall there was no effect in the whole group of hypertensive studies.  We included a total of 6 trials in this group, but the trials were very different.  The most striking difference was that the more recent trials used a more sensitive way of detecting atrial fibrillation by using ECG every year and analyzed in a central protocol.  The contrasts with the older trials like the Captoprel Prevention Project and STOP-2 in that they recorded atrial fibrillation only as an adverse event.  Looking at these 6 trials, only the two trials who used yearly ECG recordings found a positive effect of using RAS blockade, which might indicate that you need a better way of detecting atrial fibrillation, especially in this group who has a low rate of developing atrial fibrillation.  Also, in the LIFE trial, patients were included who also simultaneously had hypertension and left ventricle hypertrophy.  Patients who had left ventricle hypertrophy perhaps have the greatest benefit of RAS blockade.

     In the other group of primary prevention who had the most benefit was the group of patients with heart failure.  We have three studies with patients with heart failure and all three show a beneficial effects of RAS blockade, especially the SOLF study, a very old study, that showed a rather large benefit of RAS blockade, and these were the patients who had the most severe left ventricle function.

[1]  [2]  [3]  [4]  下一页

版面编辑:沈会会  责任编辑:其他


高血压合并心衰患者房颤治疗NavigatorM.Schneider

分享到: 更多


设为首页 | 加入收藏 | 关于我们 | 联系方式 | 招贤纳士
声明:国际循环网( www.icirculation.com)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。
京ICP备15014970号-5  互联网药品信息服务资格证书编号(京)-非经营性-2017-0063  京公网安备 11010502033353号  增值电信业务经营许可证:京ICP证150541号
国际循环 版权所有   © 2004-2024 www.icirculation.com All Rights Reserved
公司名称:北京美赞广告有限公司 公司地址:北京市朝阳区朝阳门北大街乙12号天辰大厦1座1409 电话:010-51295530