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The Korean Journal of Medicine 2010;78(3): 325-332.
본태성 고혈압 환자에서 심장의 전기적인 안정성에 대한 스타틴의 효과
김성수, 장수영, 고점석, 윤남식, 김계훈, 박형욱, 홍영준, 김주한, 안영근, 정명호, 조정관, 박종춘, 강정채, 조상기, 이승욱, 김 완, 김남호, 류제영, 조장현, 정중화
The effects of statins on electrical stability in patients with essential hypertension
Sung Soo Kim, Soo Young Jang, Jeom Seok Ko, Nam Sik Yoon, Ke Hun Kim, Hyung Wook Park, Young Joon Hong, Ju Han Kim, Young Keun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang, Sang Ki Cho, Seung Wook Lee, Wan Kim, Nam Ho Kim, Jay Young Rhew, Jang Hyun Cho, Joong Hwa Chung
Essential hypertension is the most common cardiovascular disease and is involved in the development of the various cardiac arrhythmias, including atrial fibrillation. Recently, several studies have shown that statins have anti-arrhythmic effects, including the prevention of atrial fibrillation. This study investigated the effects of statins on cardiac electrophysiologic remodeling in patients with essential hypertension using the signal-averaged electrocardiogram (ECG) and standard 12-lead ECG.
This prospective multicenter study enrolled 115 patients with hypertension. Various antihypertensive drugs were administered alone or in combination according to their blood pressure. Statins were administrated in 56 patients. Laboratory tests, a standard 12-lead ECG, and signal-averaged ECG were performed at 1, 3, 6, and 12 months. Statistical analysis was performed using paired and independent t-tests and repeated measures analysis of variance (ANOVA).
There was no significant difference in the clinical characteristics of the patients with and without statins. After antihypertensive therapy for 1 year, the P wave dispersion, high-frequency low-amplitude (HFLA) signals in the QRS complex of less than 40 µV, and T peak-to-end dispersion were increased significantly (p<0.001, p<0.05, and p<0.01, respectively) in the patients who were not taking statins, while these changes were not seen in the statin group.
These results demonstrate that electrophysiologic remodeling was progressive in patients with essential hypertension, despite antihypertensive therapy. However, combination therapy with a statin may inhibit the deterioration of inhomogeneity in atrial refractoriness and conduction disturbance. (Korean J Med 78:325-332, 2010)
Keywords: Hypertension; Statin; Electrophysiology
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