Arterial hypertension and cardiac arrhythmias

Hennersdorf, M.; Strauer, Bodo E.

doi:10.1097/00004872-200102000-00002

Cited by 62 publications

(42 citation statements)

References 103 publications

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“…14 Hypertension is a major cause of non-rheumatic AF. 15 In patients with hypertension, the risk of AF increases with age and left ventricular mass. 5 The prognostic value of hypertension in AF is somewhat conflicting.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Rate and Rhythm Control in Hypertension Patients With Atrial Fibrillation

Yıldız¹,

Yiğit

Ökçün

et al. 2008

Circ J

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trial fibrillation (AF) is the most frequent reason for hospital admission and is also the most common sustained cardiac arrhythmia, occurring in 0.4% of the adult population. 1,2 Its prevalence is age-related and increases significantly to 1-4% after 60 years of age. [1][2][3] Owing to the age structure of Turkey's population and the increasing morbidity and comorbidity, one must assume that this arrhythmia will reach an even higher prevalence. AF is associated with a significantly higher risk of systemic embolism, congestive heart failure and death. [1][2][3][4] AF and hypertension are 2 prevalent, and often coexisting, conditions in the adult population. 5-7 Their incidence increases with age, and they are responsible for considerable morbidity and mortality. 5,6 The purpose of the present study was to determine whether a strategy that attempts to restore and maintain sinus rhythm (SR) in AF will improve survival and exercise capacity among patients with hypertension. MethodsPatients aged >18 years who had hypertension and persistent AF for >48 h were included in the study. AF was defined as having: an absence of P-waves, course or fine fibrillatory waves, and completely irregular R-R intervals.The diagnosis of essential hypertension was defined as having BP >140/90 mmHg, or current use of antihyperten- Patients suffering from valvular heart diseases, coronary artery disease, heart failure, thyroid disease, renal failure, sick sinus syndrome, pulmonary embolism, acute pericarditis, diabetes mellitus, chronic obstructive lung disease, hypertrophic obstructive cardiomyopathy and atrial thrombus were excluded from the study.The patients were randomly assigned to either the rhythm control group or rate control group. The patients were kept under observation for a minumum follow-up period of 3 years, with regular weekly visits in the 1 st month and then once a month thereafter. The composite endpoints of the study were embolism, death and exercise capacity for both groups.At baseline, resting 12-lead ECG was obtained, and transthoracic echocardiography (TTE), transesophageal echocardiograph (TEE) and exercise tests were performed. At every control visit, a 12-lead ECG was taken. At the end of the 1 st year all patients underwent exercise testing.The TTE and TEE studies were performed with an Acuson 128 XP/5 ultrasound system. M-mode TTE was used to measure the left atrial dimension at end-systole and the LVEF, according to the recommendations of the American Society of Echocardiography. Food consumption was stopped at least 4 h before the TEE was done. Patients received local pharyngeal anesthesia (1% lidocaine spray) as the only premedication, and were given effective anticoagulation either with heparin or warfarin (INR levels 2.0-3.0 or APTT 2 times control, 60-80 s) before the TEE. Patients in whom the TEE did not detect any thrombus were cardioverted to SR. For cardioversion (CV), amiodarone (administered intravenously (iv)) was used (300 mg over 1 h, then 15-20 mg/kg for the remaining 23 h). If CV was not ach...

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Section: Discussionmentioning

confidence: 99%

Comparison of Rate and Rhythm Control in Hypertension Patients With Atrial Fibrillation

Yıldız¹,

Yiğit

Ökçün

et al. 2008

Circ J

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“…Hypertension and cardiac arrhythmias co-exist in many patients, and the most important promoter of ventricular arrhythmogenesis in hyper- tensives is LV hypertrophy (7,8,23). Frequent premature ventricular contractions can reduce LV systolic function (9), and reducing the premature ventricular contractions can improve the symptoms of patients (24).…”

Section: Discussionmentioning

confidence: 99%

Impaired Left Ventricular Systolic Synchronicity in Hypertensive Patients with Ventricular Arrhythmias

Tan

Wang

et al. 2007

Hypertens Res

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“…Cardiac hypertrophy is a potent risk factor for the development of cardiac arrhythmias, diastolic dysfunction, congestive heart failure, and death. 2,3 Pressure overload activates several signaling pathways in cardiac tissue. Pressure overload causes the local release of ligands, including angiotensin II and endothelin-1 in the heart.…”

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confidence: 99%

Raf-1 Kinase Is Required for Cardiac Hypertrophy and Cardiomyocyte Survival in Response to Pressure Overload

et al. 2004

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Background-Cardiac hypertrophy is a common response to pressure overload and is associated with increased mortality.Mechanical stress in the heart results in the activation of the small GTPase ras and the Raf-1/MEK/ERK signaling cascade in addition to other signaling pathways. Methods and Results-In an attempt to determine the requirement for the serine/threonine kinase Raf-1 in the pathogenesis of cardiac hypertrophy, we generated transgenic mice with cardiac-specific expression of a dominant negative form of Raf-1 (DN-Raf). DN-Raf mice appeared normal at birth, were fertile, and had normal cardiac structure and function in the absence of provocative stimulation. In response to pressure overload, cardiac extracellular signal-regulated kinase (ERK) activation was inhibited, but c-Jun N-terminal kinase (JNK) activation and p38 mitogen-activated protein kinase (MAPK) activation were normal. DN-Raf mice were sensitized to pressure overload and the development of cardiomyocyte apoptosis, and Ͼ35% of animals died within 7 days of aortic banding. Surviving DN-Raf animals were markedly resistant to the development of cardiac hypertrophy and hypertrophic gene induction in response to transverse aortic constriction. Conclusions-These results establish that Raf-1 kinase activity is essential for cardiac hypertrophy and cardiomyocyte survival in response to pressure overload.

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Arterial hypertension and cardiac arrhythmias

Cited by 62 publications

References 103 publications

Comparison of Rate and Rhythm Control in Hypertension Patients With Atrial Fibrillation

Comparison of Rate and Rhythm Control in Hypertension Patients With Atrial Fibrillation

Impaired Left Ventricular Systolic Synchronicity in Hypertensive Patients with Ventricular Arrhythmias

Raf-1 Kinase Is Required for Cardiac Hypertrophy and Cardiomyocyte Survival in Response to Pressure Overload

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