ANALYSIS OF VENTRICULAR ARRHYTHMIAS IN PATIENTS WITH DILATED CARDIOMYOPATHY - RELATIONSHIP BETWEEN THE EFFECTS OF ANTIARRHYTHMIC AGENTS AND SEVERITY OF MYOCARDIAL LESIONS

被引:9
作者
TAKARADA, A [1 ]
YOKOTA, Y [1 ]
FUKUZAKI, H [1 ]
机构
[1] KOBE UNIV,SCH MED,DEPT INTERNAL MED 1,KOBE 650,JAPAN
来源
JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION | 1990年 / 54卷 / 03期
关键词
arrhythmias; biopsy; cardiomyopathy; Dilated; Endomyocardial; Ventricular;
D O I
10.1253/jcj.54.260
中图分类号
N09 [自然科学史]; B [哲学、宗教];
学科分类号
01 ; 0101 ; 010108 ; 060207 ; 060305 ; 0712 ;
摘要
In order to investigate the usefulness of antiarrhythmic drugs in patients with dilated cardiomyopathy (DCM), 42 patients with DCM were studied using 24h ambulatory ECG monitoring, echocardiography and right ventricular endomyocardial biopsy. All 42 patients had ventricular arrhythmias with a Lown's classification of grade II or greater (grade IVb, 25; IVa, 7; III, 7; II, 3). The patients with grade IV arrhythmias tended to have greater dilating of the left ventricle and more pronounced interstitial myocardial fibrosis than patients with lower grades. Following procainamide and/or disopyramide treatment the severity of the ventricular arrhythmias improved in 12 (29%) of the 42 patients, did not change in 27 patients (64%), and deteriorated in 3 patients (7%). Treatment with aprindine or mexiletine was effective in 7 (50%) of the 14 patients who did not respond to procainamide and/or disopyramide. Although there were no significant differences in left ventricular dimension and contractility between patients in each group who did and did not respond to antiarrhythmic treatment, those who did respond had less interstitial myocardial fibrosis. Thus, in the procainamide and/or disopyramide treated group the percent interstitial fibrosis in responding vs nonresponding patients was 10.3 ± 4.1% vs 18.7 ± 8.3% (p < 0.05) respectively, while in the group treated with aprindine or mexiletine these figures were 13.0 ± 3.2% vs 26.1 ± 7.9% (p < 0.02), respectively. In conclusion, the effect of antiarrhythmic drugs in DCM was dependent on the severity of the pathological changes in the myocardium, and antiarrhythmic drugs should be appropriately used for the management of ventricular arrhythmias in DCM. © 1990, The Japanese Circulation Society. All rights reserved.
引用
收藏
页码:260 / 271
页数:12
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