004 静脉注射Dofetilide迅速终止心房纤颤与心房扑动的疗效和安全性

研究心房纤颤/心房扑动[(atrial fibrillation;AF)/(atrial flutter;AFI)]患者69例,男46、女23,平均年龄60岁(25～75岁),随机分成4组(即输注Dofetilide 2μg/kg组、4μg/kg组、8μg/kg组和安慰剂对照组)。 研究结果,转律的成功率分别为：2μg/kg组为25％(4/16)、4μg/kg组为29％(5/17)、8μg/kg组为39％(7/18);对照组为6％(1/18)。 AF/AFI持续时间决定着转律的成功率,持续时间＜24小时者,成功率为67％(4/6)、1～7天者为36％(4/11)、7天以上者为24％(8/34)。 输注Dofetilide总的转律成功率,单剂一次输注为31％(16/51;p=0.03;95％CI 19～46);二次输注为38％(26/68;p=0.009;95％CI 27～51)。安慰剂对照组则为6％(1/18;95％CI0～27)。转为窦律的平均时间是从开始输注起的22分钟(5-49分钟)。     

Tropical endomyocardial fibrosis (Davies’ disease): case report demonstrating the role of magnetic resonance imaging

Tropical endomyocardial fibrosis (TEMF), a restrictive cardiomyopathy of unclear etiology, is an endemic disease in equatorial Africa, South America and India. The patients are usually young, the onset of the disease and its clinical manifestations insidious, and the prognosis poor. We currently present a 50-year-old Congolese female who was referred with symptoms of progressive right-sided heart failure due to isolated TEMF of the right ventricle. Surgical resection of regional endomyocardial fibrosis was not possible and our patient was referred for cardiac transplantation. Cardiac magnetic resonance imaging (CMR) demonstrated the primary and secondary structural and functional abnormalities. CMR seems ideally suited to diagnose this condition and monitor response to medical and/or surgical therapy.