Tregubov V G, Pokrovsky V M, Nazhalkina N M
Federal State Budgetary Educational Institution of Higher Education "Kuban State Medical University" of the Ministry of Health of the Russian Federation.
Kardiologiia. 2017;57(S1):345-354. doi: 10.18087/cardio.2396.
To determine efficacy of bisoprolol and sotalol treatments in patients with paroxysmal supraventricular tachycardia (SVT) and essential hypertension (EH) considering effects of these treatments on the regulatory adaptive status (RAS).
The study included 49 patients with paroxysmal SVT associated with stage II-III EH randomized to two groups of either bisoprolol (6.9±2.2 mg/day, n=25) or sotalol (162.5±46.2 mg/day, n=24) treatment. Lisinopril (14.5±3.9 and 14.3±4.7 mg/day) and, if indicated, atorvastatin (15.4±3.8 mg/day, n=9 and 16.0±4.8 mg/day, n=10), and acetylsalicylic acid (91.5±14.7 mg/day, n=12 and 94.1±16.5 mg/day, n=14) were administered as a part of combination therapy. Quantitative evaluation of RAS (cardiorespiratory synchronism test), EchoCG, triplex scanning of brachiocephalic arteries, treadmill test, 6-min walk test, 24-h BP and ECG monitoring, and subjective assessment of the quality of life were performed at baseline and after 6 months of therapy.
Both regimens of the combination drug therapy comparably improved the structural and functional status of the heart, increased exercise tolerance, effectively suppressed SVT paroxysms, and improved the quality of life. In this process, sotalol reduced RAS to a lesser extent that bisoprolol.
In patients with paroxysmal SVT associated with stage II-III EH, the sotalol treatment as a part of the combination therapy may be preferable due to fewer adverse effects on RAS compared to bisoprolol.
考虑比索洛尔和索他洛尔治疗对阵发性室上性心动过速(SVT)合并原发性高血压(EH)患者调节适应性状态(RAS)的影响,确定这两种治疗方法的疗效。
该研究纳入了49例阵发性SVT合并II - III期EH的患者,随机分为两组,分别接受比索洛尔(6.9±2.2毫克/天,n = 25)或索他洛尔(162.5±46.2毫克/天,n = 24)治疗。作为联合治疗的一部分,给予赖诺普利(14.5±3.9和14.3±4.7毫克/天),并在必要时给予阿托伐他汀(15.4±3.8毫克/天,n = 9;16.0±4.8毫克/天,n = 10)以及阿司匹林(91.5±14.7毫克/天,n = 12;94.1±16.5毫克/天,n = 14)。在基线和治疗6个月后,进行RAS的定量评估(心肺同步测试)、超声心动图、头臂动脉的三维扫描、跑步机测试、6分钟步行测试、24小时血压和心电图监测,以及生活质量的主观评估。
两种联合药物治疗方案均同等程度地改善了心脏的结构和功能状态,提高了运动耐力,有效抑制了SVT发作,并改善了生活质量。在此过程中,索他洛尔对比索洛尔而言,对RAS的降低程度较小。
对于阵发性SVT合并II - III期EH的患者,作为联合治疗的一部分,索他洛尔治疗可能更可取,因为与比索洛尔相比,其对RAS的不良反应较少。