Kanorskiĭ S G, Kanorskaia Iu S
Kardiologiia. 2010;50(7):31-7.
We examined 212 patients aged 52-70 years with persistent symptomatic atrial fibrillation (AF). Comparison of AF substrates in patients with (n=26) and without (n=27) type 2 diabetes mellitus (DM2) revealed slowing of intraatrial conduction, increased vulnerability of atria, and more pronounced worsening of left ventricular diastolic function among DM2 patients. Comparison of groups of patients with (n=32) and without (n=33) diabetic cardiac autonomic neuropathy (CAN) revealed augmentation of adrenergic influences on the heart and comparatively higher antirecurrence efficacy of sotalol among patients with CAN. In 94 patients with type 2 DM complicated with CAN after randomization we administered antiarrhythmic therapy with sotalol in combination with perindopril (n=33), lipoic acid (n=31), perindopril and lipoic acid (n=30), and compared results with sotalol monotherapy. In 6 months percentage of patients in sinus rhythm was significantly higher in the group of combination therapy (sotalol plus perindopril plus lipoic acid). This was probably a result of simultaneous correction of disturbances caused by both "diabetic cardiomyopathy" and CAN.
我们对212例年龄在52至70岁之间的持续性症状性心房颤动（AF）患者进行了研究。对患有2型糖尿病（DM2）（n = 26）和未患2型糖尿病（n = 27）的患者的房颤基质进行比较，结果显示DM2患者的心房内传导减慢、心房易损性增加以及左心室舒张功能恶化更为明显。对患有糖尿病性心脏自主神经病变（CAN）（n = 32）和未患糖尿病性心脏自主神经病变（n = 33）的患者组进行比较，结果显示CAN患者中肾上腺素能对心脏的影响增强，索他洛尔的抗复发疗效相对较高。在94例随机分组后患有2型糖尿病合并CAN的患者中，我们给予索他洛尔联合培哚普利（n = 33）、硫辛酸（n = 31）、培哚普利和硫辛酸（n = 30）进行抗心律失常治疗，并将结果与索他洛尔单药治疗进行比较。6个月时，联合治疗组（索他洛尔加培哚普利加硫辛酸）窦性心律患者的百分比显著更高。这可能是同时纠正“糖尿病性心肌病”和CAN所引起的紊乱的结果。
