肾素-血管紧张素系统阻断在心房颤动管理中的作用。
The role of the renin-angiotensin system blocking in the management of atrial fibrillation.
作者信息
Cliff Brett, Younis Naveed, Hama Salam, Soran Handrean
机构信息
University Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, ManchesterUK.
Department of Diabetes and Endocrinology, South Manchester University Hospitals NHS Foundation Trust, ManchesterUK.
出版信息
J Drug Assess. 2012 Mar 5;1(1):55-64. doi: 10.3109/21556660.2012.672353. eCollection 2012.
OBJECTIVE
To review current available evidence for the role of renin-angiotensin system blockade in the management of atrial fibrillation.
METHOD
We conducted a PubMed and Medline literature search (January 1980 through July 2011) to identify all clinical trials published in English concerning the use of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers for primary and secondary prevention of atrial fibrillation. We also discussed renin-angiotensin system and its effects on cellular electrophysiology.
CONCLUSION
The evidence from the current studies discussed does not provide a firm definitive indication for the use of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers in the primary or secondary prevention of atrial fibrillation. Nevertheless, modest benefits were observed in patients with left ventricular dysfunction. In view of the possible benefits and the low incidence of side-effects with angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, they can be given to patients with recurrent AF, specifically those with hypertension, heart failure and diabetes mellitus.
目的
回顾肾素 - 血管紧张素系统阻断在心房颤动管理中的现有证据。
方法
我们进行了PubMed和Medline文献检索（1980年1月至2011年7月），以识别所有以英文发表的关于使用血管紧张素转换酶抑制剂或血管紧张素II受体阻滞剂进行心房颤动一级和二级预防的临床试验。我们还讨论了肾素 - 血管紧张素系统及其对细胞电生理学的影响。
结论
所讨论的当前研究证据并未为使用血管紧张素转换酶抑制剂或血管紧张素II受体阻滞剂进行心房颤动的一级或二级预防提供确凿的明确指征。然而，在左心室功能不全的患者中观察到了适度的益处。鉴于血管紧张素转换酶抑制剂和血管紧张素II受体阻滞剂可能的益处以及副作用发生率较低，它们可用于复发性房颤患者，特别是那些患有高血压、心力衰竭和糖尿病的患者。
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