缬沙坦对风湿性心脏病心房颤动患者心房重构的影响

目的探讨缬沙坦对风湿性心脏病心房颤动患者心房重构的影响。方法 50例风湿性心脏病二尖瓣病变合并心房颤动患者分为缬沙坦组27例和对照组23例,对照组给予利尿剂、洋地黄制剂、β受体阻滞剂等常规治疗,缬沙坦组在常规治疗的基础上加用缬沙坦治疗。应用超声心动图测定左心房内径和容积,记录二尖瓣血流频谱A峰流速(VA)和左心房射血力(LAEF)。行心脏外科手术时取右心耳组织,并应用V-G染色法和VIDAS-21图像分析系统测量心房组织胶原容积分数(CVF)。结果治疗后缬沙坦组左心房前后径、最大容积、最小容积、心房CVF明显低于对照组,VA、LAEF明显高于对照组,差别均有统计学意义(P<0.05)。结论缬沙坦可明显降低风湿性心脏病心房颤动患者左心房重构程度,从而阻止心房颤动的发生发展。

Effect of valsartan on remodeling of atrium cordis in patients with rheumatic heart disease complicating atrial fibrillation

Objective To evaluate the effect of valsartan on atrial remodeling in patients with rheumatic heart disease complicating atrial fibrillation.Methods Fifty patients with mitral lesion and atrial fibrillation were divided randomly into control group and valsartan group,twenty-three patients in control group were treated with conventional therapy including diuretic,digitalis preparation and β-blocker,twenty-seven patients in treatment group were treated with valsartan on the basis of above conventional therapy.Left atrium（LA） bore and volume was detected by echocardiogram,peak A velocity（VA） and left atrium ejection force（LAEF） were measured.Atrial tissues were obtained from the right atrial appendage during heart surgery.Atrial collagen volume fraction（CVF） was analyzed respectively by V-G staining method and IDAS-21 image analysis system.Results Compared with control group,the anteroposterior diameter of LA decreased,left atrium maximal volume and left atrium minimal volume were significantly lower while VA and LAEF were higher in valsartan group,the differences have statistical significance（P0.05）.Conclusion Valsartan can reduce the development of atrial fibrillation by decreasing significantly the level of atrial remodeling of patients with rheumatic heart disease complicating atrial fibrillation.