Effect of preload reducing therapy on right ventricular size and function in patients with arrhythmogenic right ventricular cardiomyopathy.
Adult
Arrhythmogenic Right Ventricular Dysplasia
/ diagnosis
Dose-Response Relationship, Drug
Drug Combinations
Echocardiography, Doppler
/ methods
Female
Follow-Up Studies
Heart Ventricles
/ diagnostic imaging
Humans
Hydrochlorothiazide
/ administration & dosage
Isosorbide Dinitrate
/ administration & dosage
Male
Middle Aged
Organ Size
Retrospective Studies
Spironolactone
/ administration & dosage
Stroke Volume
/ drug effects
Time Factors
Vasodilator Agents
/ administration & dosage
Ventricular Function, Right
/ drug effects
Arrhythmogenic right ventricular cardiomyopathy
Echocardiography
Hydrochlorothiazide
Nitrates
Preload reduction
Spironolactone
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
30
11
2020
revised:
23
02
2021
accepted:
09
03
2021
pubmed:
17
3
2021
medline:
11
2
2022
entrez:
16
3
2021
Statut:
ppublish
Résumé
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden cardiac death in young people and athletes. To date, no treatment has proven to slow the progression of the disease. Preload reducing agents such as nitrates and diuretics have shown promising results in preventing training-induced development of ARVC in a murine model. The purpose of this study was to describe our experience with preload reducing therapy in patients with ARVC and symptomatic right ventricular (RV) dysfunction. We performed retrospective chart review of prospectively collected registry data and included 20 patients with definite ARVC who had serial echocardiographic measurements and an implantable cardioverter-defibrillator. Six of the 20 patients with RV end-diastolic area (RVEDA) above median (>25 cm Patients who received preload reducing agents (n = 6) were older and had larger RVs with lower FAC at baseline. However, treatment with preload reducing agents was associated with less RVEDA enlargement during mean 3.3 (range 1-6.7) years of treatment in multivariate analysis (% change in RVEDA associated with treatment -7.71; 95% confidence interval -13.29 to -2.13; P = .007). Preload reducing agents show promising results in slowing RV enlargement in patients with ARVC and show possible disease-modifying potential.
Sections du résumé
BACKGROUND
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden cardiac death in young people and athletes. To date, no treatment has proven to slow the progression of the disease. Preload reducing agents such as nitrates and diuretics have shown promising results in preventing training-induced development of ARVC in a murine model.
OBJECTIVE
The purpose of this study was to describe our experience with preload reducing therapy in patients with ARVC and symptomatic right ventricular (RV) dysfunction.
METHODS
We performed retrospective chart review of prospectively collected registry data and included 20 patients with definite ARVC who had serial echocardiographic measurements and an implantable cardioverter-defibrillator. Six of the 20 patients with RV end-diastolic area (RVEDA) above median (>25 cm
RESULTS
Patients who received preload reducing agents (n = 6) were older and had larger RVs with lower FAC at baseline. However, treatment with preload reducing agents was associated with less RVEDA enlargement during mean 3.3 (range 1-6.7) years of treatment in multivariate analysis (% change in RVEDA associated with treatment -7.71; 95% confidence interval -13.29 to -2.13; P = .007).
CONCLUSION
Preload reducing agents show promising results in slowing RV enlargement in patients with ARVC and show possible disease-modifying potential.
Identifiants
pubmed: 33722762
pii: S1547-5271(21)00210-1
doi: 10.1016/j.hrthm.2021.03.018
pii:
doi:
Substances chimiques
Drug Combinations
0
Vasodilator Agents
0
buthiazide, spironolactone drug combination
0
Hydrochlorothiazide
0J48LPH2TH
Spironolactone
27O7W4T232
Isosorbide Dinitrate
IA7306519N
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1186-1191Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.