목적: 고혈압은 가장 흔한 심혈관계 질환으로 심방세동을 비롯하여 다양한 부정맥의 원인이 되고 있다. 고혈압이 부정맥 발생에 관여하는 인자는 명확하게 규명되어 있지 않다. 본 연구는 본태성 고혈압 환자에서 표준 12유도 심전도와 신호평균 심전도를 추적검사하여 항고혈압 약물치료 과정 중에 일어나는 심장의 전기생리학적 변화를 관찰하고 스타틴이 여기에 어떤 영향을 미치는지 알아보고자 시행되었다.
결론: 이상의 결과로 고혈압 환자에서 심장의 전기생리학적인 변화는 항고혈압치료에도 불구하고 진행하며 statin의 병용 투여가 심방 불응기의 비균일성의 악화를 억제하고 심실 전도 지연과 심실 불응기의 통벽성 비균일성의 악화를 억제함을 알 수 있었다.Background/Aims: Essential hypertension is the most common cardiovascular disease and is involved in the development of the various cardiac arrhythmias, including atrial fibrillation. Recently, several studies have shown that statins have anti-arrhythmic effects, including the prevention of atrial fibrillation. This study investigated the effects of statins on cardiac electrophysiologic remodeling in patients with essential hypertension using the signal-averaged electrocardiogram (ECG) and standard 12-lead ECG.
Methods: This prospective multicenter study enrolled 115 patients with hypertension. Various antihypertensive drugs were administered alone or in combination according to their blood pressure. Statins were administrated in 56 patients. Laboratory tests, a standard 12-lead ECG, and signal-averaged ECG were performed at 1, 3, 6, and 12 months. Statistical analysis was performed using paired and independent t-tests and repeated measures analysis of variance (ANOVA).
Conclusions: These results demonstrate that electrophysiologic remodeling was progressive in patients with essential hypertension, despite antihypertensive therapy. However, combination therapy with a statin may inhibit the deterioration of inhomogeneity in atrial refractoriness and conduction disturbance.