International journal of cardiology · 2011
Cardiac remodeling with rhythm versus rate control strategies for atrial fibrillation in patients with heart failure: insights from the AF-CHF echocardiographic sub-study.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Henrard Valérie, Ducharme Anique, Khairy Paul, Gisbert Alejandro, Roy Denis, Levesque Sylvie, Talajic Mario, Thibault Bernard, Racine Normand, White Michel, Guerra Peter G, Tardif Jean-Claude, AF-CHF investigators
Аннотация
BACKGROUND: In patients with heart failure and atrial fibrillation, the AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial did not demonstrate the superiority of rhythm control (RhyC) over a rate control (RaC) strategy on cardiovascular mortality. Nevertheless, deleterious hemodynamic effects of atrial fibrillation can lead to further decrease in left ventricular (LV) function and progression of symptoms. This echocardiographic sub-study was designed to compare the effects of the two treatment strategies on LV ejection fraction (LVEF), chamber volumes and dimensions, valvular regurgitation and functional status.
METHODS AND RESULTS: A total of 59 patients (29 RhyC, 30 RaC) aged 67±8 years (14% women), enrolled in the AF-CHF trial at the Montreal Heart Institute underwent standardized echocardiograms at baseline and at 12 months. Mean LVEF at baseline was severely depressed (RhyC: 27.0±4.9% and RaC: 27.6±7.4%, p=0.73), and improved to a similar degree in both groups (RhyC: +8.0±10.4% and RaC: +4.5±10.6, both p<0.05; p=0.19 for RhyC versus RaC). Other echocardiographic parameters, such as LV end-systolic volume index and degree of mitral and tricuspid regurgitation, remained unchanged. New York Heart Association functional class and distance walked in 6 min improved significantly in both groups (RhyC: +48.9±78.7 m and RaC: +47.2±96.7 m, both p≤0.01), with no difference between RhyC and RaC strategies.
CONCLUSIONS: Improvements in LVEF and functional status are observed after 12 months in patients with heart failure and atrial fibrillation, regardless of whether rate or rhythm control strategies are used.
METHODS AND RESULTS: A total of 59 patients (29 RhyC, 30 RaC) aged 67±8 years (14% women), enrolled in the AF-CHF trial at the Montreal Heart Institute underwent standardized echocardiograms at baseline and at 12 months. Mean LVEF at baseline was severely depressed (RhyC: 27.0±4.9% and RaC: 27.6±7.4%, p=0.73), and improved to a similar degree in both groups (RhyC: +8.0±10.4% and RaC: +4.5±10.6, both p<0.05; p=0.19 for RhyC versus RaC). Other echocardiographic parameters, such as LV end-systolic volume index and degree of mitral and tricuspid regurgitation, remained unchanged. New York Heart Association functional class and distance walked in 6 min improved significantly in both groups (RhyC: +48.9±78.7 m and RaC: +47.2±96.7 m, both p≤0.01), with no difference between RhyC and RaC strategies.
CONCLUSIONS: Improvements in LVEF and functional status are observed after 12 months in patients with heart failure and atrial fibrillation, regardless of whether rate or rhythm control strategies are used.