Nidhal Bouchahda, Mouna Bader, Aymen Najjar, Fathia Mghaieth Zghal, Ghada Sassi, Mohamed Sami Mourali, Mejdi Ben Messaoud
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引用次数: 0
Abstract
BACKGROUND AND OBJECTIVE: Left atrial strain (LAS) has prognostic value in patients with atrial fibrillation (AF). Consequently, therapies that improve LAS may help reduce AF-related adverse cardiac events. We aimed to compare how digoxin and bisoprolol modulate LAS in patients with AF being treated with rate control.
Methods: This was a bicentric randomized controlled trial. Patients with AF, naïve to beta-blockers and digoxin, and scheduled for treatment with a rate control strategy were randomized to receive oral bisoprolol 5-10 mg daily or digoxin 0.25 mg daily. The primary aim was to compare the change in peak LAS before and after 30 days of treatment between the two groups.
Results: A total of 60 patients, equally distributed between the two groups, completed the trial. By day 30, there was no significant difference in global peak LAS between the groups. However, when analyzed separately, the two-chamber view showed a significantly higher peak LAS in the digoxin group than in the BB group (mean 7.5 ± standard deviation 3.2% vs. 5.9 ± 3.4%; p = 0.004). Similarly, the four-chamber view also showed a higher peak LAS in the digoxin group (7.2 ± 3.6% vs. 6.4 ± 3.8%; p = 0.047). Considering the entire LAS curve rather than solely the peak value, digoxin significantly increased all LAS curves. In the global and four-chamber view, the digoxin maximum effect occurred significantly earlier than the peak of the LAS curve (p < 0.001). This effect remained constant over the cardiac cycle in the two-chamber curve (p < 0.001).
Conclusion: Our findings suggest that, in patients with rate-controlled AF, digoxin positively modulates LAS when compared with bisoprolol.
背景与目的：左心房应变（LAS）在房颤（AF）患者中具有预后价值。因此，改善LAS的治疗可能有助于减少af相关的不良心脏事件。我们的目的是比较地高辛和比索洛尔如何调节心率控制治疗的房颤患者的LAS。方法：采用双中心随机对照试验。对-受体阻滞剂和地高辛naïve，并计划以速率控制策略治疗的AF患者随机接受每日口服比索洛尔5-10毫克或地高辛0.25毫克。主要目的是比较两组治疗前和治疗后30天LAS峰值的变化。结果：共60例患者完成试验，平均分布于两组。到第30天，两组间全球LAS峰值无显著差异。然而，当单独分析时，双室视图显示地高辛组的LAS峰值明显高于BB组(平均7.5±标准差3.2% vs. 5.9±3.4%；p = 0.004)。同样，四腔镜也显示地高辛组的LAS峰值更高(7.2±3.6% vs. 6.4±3.8%；p = 0.047)。考虑到整个LAS曲线，而不仅仅是峰值，地高辛显著提高了所有LAS曲线。在全局和四室视图中，地高辛的最大作用明显早于LAS曲线的峰值(p)。结论：我们的研究结果表明，在速率控制的房颤患者中，与比索洛尔相比，地高辛正调节LAS。临床试验注册号：NCT05540600， https://clinicaltrials.gov。
期刊介绍：
Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents.
Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations.
The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.
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