The role of spironolactone in the metabolism of serum type I collagen in elderly patients with atrial fibrillation.

OBJECTIVE

This study aimed to explore the possible mechanism of spironolactone in reduction of atrial fibrosis in elderly patients with atrial fibrillation.

PATIENTS AND METHODS

67 patients with atrial fibrillation and 30 matching patients with sinus rhythm were included into this study, in which the former patients were randomly divided into the conventional treatment group (33 cases) and spironolactone (20 mg/d) treatment group (34 cases). They underwent follow-ups for 6 months. The levels of serum aldosterone, PICP (propeptide of type I procollagen) and CITP (carboxy-terminal cross-linking telopeptide of type I collagen) were determined before and after treatment.

RESULTS

The concentrations of serum PICP, CITP and aldosterone and left atrial size in the atrial fibrillation group were all higher than the control group (t values were 7.982, 5.950, 9.309, 9.050, respectively, p < 0.01), with a significant statistical difference. The concentrations of serum PICP and aldosterone were both positively corelated to the left atrial size in the atrial fibrillation group (r values were 0.302 and 0.369, respectively). The levels of serum aldosterone and PICP after treatment were both decreased compared to those before treatment in the spironolactone treatment group and conventional treatment group, especially in the spironolactone treatment group. There were statistical differences in the levels of serum aldosterone and PICP after treatment between the two groups (t values were 2.872 and 3.054, respectively, p < 0.01).

CONCLUSIONS

Spironolactone could reduce the levels of serum aldosterone and PICP in patients with atrial fibrillation, so as to reduce the atrial fibrosis and delay the occurrence and development of atrial fibrillation.