超声观察缬沙坦对非瓣膜性房颤复律后左心房功能改变的影响

A echocardiographic study of Valsartan on recovery of left atrial systolic function after conversion to sinus rhythm in patients with nonvalvular atrial fibrillation.

目的研究缬沙坦对非瓣膜性房颤复律后左心房功能改变的影响。方法将28例患者随机分成Ⅰ、Ⅱ两组,Ⅰ组服用缬沙坦,40mg,1次/d,Ⅱ组服用安慰剂,时间均为3个月。超声观察了28例患者经药物复律后第1,15,30天时二尖瓣的血流特点。结果①Ⅰ、Ⅱ两组患者复律后2周内的房缩期二尖瓣峰速血流、速度积分均较显著增大,且此后两周内渐渐增大,而同期的左室舒张早中期血流蜂速、速度积分减小。②Ⅰ、Ⅱ两组患者间复律后第1,15天时的房缩期二尖瓣峰速血流、速度积分差异均无统计学意义(P>0.05),而Ⅰ组患者复律后第30天时的房缩期二尖瓣峰速血流、速度积分均较Ⅱ组显著增大(P<0.05)。③复律前两组患者之间的左室舒张末容积、EF、FS差异无统计学意义(P>0.05),复律后30d时Ⅰ组患者的EF较Ⅱ组显著增大(P<0.05),但两组间的FS、左室舒张末内径差异无统计学意义(P>0.05)。结论缬沙坦可以在一定程度上影响非瓣膜性房颤患者复律后左房功能的改变。

Objective To evaluate the effect of valsartan on recovery of left atrial systolic function in the patients with nonvalvular atrial fibrillation.Methods 28 patients with nonvalvular atrial fibrillation were randomly divided into two greups.The patients in group Ⅰ were given valsartan for 12 weeks while the patients in group Ⅱ were given placebo during the same time.Transmitral doppler patterns in 28 patients with nonvalvula atrial fibrillation were followed up within the first day and on day 15, 30 after cardioversion.Results ①There was a significient increase in peak A-wave velocity and velocity-throe integral of A-wave during the first two weeks and a gradual increase within the later two weeks while the peak E-wave velocity and velocity-time integral of E-wave desended in two groups. ②There was no significantly difference in peak A-wave velocity and velocity-time integral of A-wave velocity and velocity-time integral of A-wave on 30 day after cardioversion were larger in group Ⅰ than those in group Ⅱ . ③There was no significantly difference in left ventricular end diastolic volume, EF and FS between two groups before treatment and there was no significantly difference in left ventricular end diastolic volume and FS on 30 day after cardioversion.EF on day 30 after cardioversion in group I was larger than those in group Ⅱ . Conclusion Valsartan could influence the recovery of left atrial systolic function after ardioversion to some degree in the patients with nonvalvular atrial ribrillation.