缬沙坦对单纯收缩期高血压伴阵发性心房颤动的疗效

Effect of valsartan in treatment of isolated systolic hypertension with paroxysmal atrial fibrillation

目的探讨缬沙坦对单纯收缩期高血压伴阵发性心房颤动(简称房颤)患者的疗效。方法将67例单纯收缩期高血压伴阵发性房颤患者随机分成缬沙坦治疗组与氨氯地平对照组,比较两组用药6个月后血压、房颤发作情况、心电图P波时限(PWD)以及左房内径(LAD)、容积(LAV)、血浆脑钠肽(BNP)水平的变化。结果两组血压均达到目标水平,且无差异。与对照组比较,治疗组维持窦性心律比例更高(82.8%vs53.1%,P<0.05);PWD、LAD、LAV、血浆BNP水平下降更明显(P均<0.05)。PWD与LAD、LAV呈正相关。结论缬沙坦有益于单纯收缩期高血压伴阵发性房颤患者维持窦性心律,并可以改善左房结构重构和电重构。

Objective To observe the effect of valsartan in treatment of isolated systolic hypertensive patients with paroxysmal atrial fibrillation（PAF）. Methods Sixty-seven hypertension patients with PAF were randomly divided into two groups. The trial group were treated with valsartan and the control group were treated with amlodipine. The rate of sinus rhythm in two groups were compared. The changes of plasma brain natriuretic peptide（BNP） and P wave duration（PWD） were observed. Left atrial size of patients were checked with echocardiogram. Results The rate of sinus rhythm was markedly higher in trial group than that in the control group after six months of follow-up （82.8% vs 53.4% ,P 〈 0.05 ）. Compared with the control group, PWD and the concentration of BNP, and left atrial diameter（LAD） and volume（LAV） in the trial group were all significantly reduced （ all P 〈 0.05 ）. PWD was positively correlated with LAD and LAV. Conclusion Valsartan can reduce the occurrence and the recurrence of PAF in isolated systolic hypertensive patients and improve left atrial electro- remodeling and structural-remodeling.