ANALYSIS OF VENTRICULAR ARRHYTHMIAS IN PATIENTS WITH DILATED CARDIOMYOPATHY : Relationship between the Effects of Antiarrhythmic Agents and Severity of Myocardial Lesions

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概要

• 論文の詳細を見る

• 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 non-responding patients was 10.3 ± 4.1% vs 1 8.7 ± 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.

• 社団法人日本循環器学会の論文
• 1990-03-20

著者

• Fukuzaki H

  Miki City Hospital Department Of Cardiology

• Yokota Yoshiyuki

  Division Of Cardiovascular And Respiratory Medicine Kobe University Graduate School Of Medicine

• FUKUZAKI Hisashi

  The 1st Department of Internal Medicine. Kobe University School of Medicine

• Takarada Akira

  The First Department of Internal Medicine, Kobe University School of Medicine

• Yasaka Yoshinori

  Department Of Cardiology Himeji Cardiovascular Center

• Takarada Akira

  Department Of Cardiology Himeji Cardiovascular Center

• Yokota Yoshiyuki

  The 1st Department of Internal Medicine, Kobe University School of Medicine

• Takarada Akira

  The 1st Department of Internal Medicine, Kobe University School of Medicine

• Yoshida Y

  Faculity Of Health Science Kobe University School Of Medicine

• Fukuzaki Hisashi

  Department Of Thoracie Srugery Osaka Medical College

• Fukuzaki Hisashi

  The 1st Department Of Internal Medicine Kobe University School Of Medicine

• Fukumoto Hitoshi

  Department Of Thoracic Surgery Osaka Medical College

• Fukuzaki Hisashi

  The First Department Of Internal Medicine Kobe University

• Yokota Yoshiyuki

  The 1st Department Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  Dept. Of Int. Med. Div1 Kobe Univ.

• Fukuzakl Hisashi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Fukuzaki Hisashi

  Internal Medicine Division I Kobe University

• Fukuzaki Hisashi

  The 1st.dept.of Inter. Med Kobe Univ. School Of Med.

• Takarada Akira

  First Division Department Of Internal Medicine Kobe University School Of Medicine

• Yoshida Yutaka

  Dept. Of Intern. Med. Div. I Kobe Univ. School Of Med.

• Fukumoto Hitoshi

  Department Of Thoracie Srugery Osaka Medical College

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