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학술저널
저자정보
최종일 (고려대학교) 정재승 (고려대학교) 김민경 (Kim Min Kyung’s Pathology Clinic Seoul Korea) 심재민 (고려대학교) 김진석 (Division of Cardiology Department of Internal Medicine Korea University Medical Center) 임홍의 (고려대학교) Sang Weon Park (Korea University College of Medicine) 김영훈 (고려대학교)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.46 No.3
발행연도
2016.1
수록면
335 - 342 (8page)

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Background and Objectives: Angiotensin-II receptor blockers (ARBs) are known to reduce the development of atrial fibrillation (AF)through reverse-remodeling. However, the effect of ARBs on thrombogenicity in AF remains unknown. Materials and Methods: Twelve dogs were assigned to control (n=4), ARB (candesartan cilexitil 10 mg/kg/day p.o., 12 weeks; n=4), orsham (n=4) groups. Sustained AF was induced by rapid atrial pacing. Both arterial and venous serum levels of tissue inhibitor of matrixmetalloproteinase-1, von Willebrand factor, P-selectin, and vascular cell adhesion molecule-1 (VCAM-1) were measured at baseline andduring AF (0, 4, and 12 weeks) with enzyme-linked immunosorbent assay. Biopsies from both atria including the appendages wereperformed to semi-quantitatively assess endocardial and myocardial fibrosis after 12 weeks. Results: The serum levels of bio-markers were not significantly different at baseline or during AF between the control and the candesartangroups. The levels were not significantly different over time, but there was a trend toward a decrease in arterial VCAM-1 from 4 to 12weeks in the candesartan group compared to the control group. The grades of endocardial fibrosis after 12 weeks but not those ofmyocardial fibrosis were slightly reduced in the candesartan group compared to the control group. Conclusion: This study did not show that the ARB candesartan significantly reverses thrombogenicity or fibrosis during AF. Future studiesusing a larger number of subjects are warranted to determine the therapeutic effect of renin-angiotensin-aldosterone system blockadeon prothrombogenic processes in AF.

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