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Improved rate control reduces cardiac troponin T levels in permanent atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature261405
Source
Clin Cardiol. 2014 Jul;37(7):422-7
Publication Type
Article
Date
Jul-2014
Author
Sara R Ulimoen
Steve Enger
Jon Norseth
Are H Pripp
Michael Abdelnoor
Harald Arnesen
Knut Gjesdal
Arnljot Tveit
Source
Clin Cardiol. 2014 Jul;37(7):422-7
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - blood - diagnosis - drug therapy - physiopathology
Biological Markers - blood
Carbazoles - therapeutic use
Cross-Over Studies
Diltiazem - therapeutic use
Down-Regulation
Female
Heart Rate - drug effects
Humans
Male
Metoprolol - therapeutic use
Middle Aged
Norway
Propanolamines - therapeutic use
Prospective Studies
Time Factors
Treatment Outcome
Troponin T - blood
Verapamil - therapeutic use
Abstract
Detectable levels of troponins are often found in serum of patients with atrial fibrillation (AF), and recent reports suggest that Tn concentrations are independently related to patient prognosis.
We hypothesized that treatment with common rate-reducing drugs might lower the levels of cardiac troponin T (TnT) in patients with permanent AF. We also wanted to investigate whether the different drugs would impact the Tn levels differently.
Sixty patients were included (mean age 71 ± 9 years, 18 women) in this randomized crossover study. All patients had stable, permanent AF without ischemic heart disease or congestive heart failure. Diltiazem 360 mg, verapamil 240 mg, metoprolol 100 mg, and carvedilol 25 mg were administered once daily for 3 weeks, in a randomized sequence. At baseline and on the last day of each treatment period, TnT concentrations were measured at rest and after a maximal exercise test.
TnT was detectable in all patients. In 22% of the patients, TnT concentrations were above the threshold normally used for diagnosing myocardial infarction. All drugs reduced the levels of TnT significantly compared with baseline (P
PubMed ID
24700386 View in PubMed
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Rate-control drugs affect variability and irregularity measures of RR intervals in patients with permanent atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature267591
Source
J Cardiovasc Electrophysiol. 2015 Feb;26(2):137-41
Publication Type
Article
Date
Feb-2015
Author
Valentina D A Corino
Sara R Ulimoen
Steve Enger
Luca T Mainardi
Arnljot Tveit
Pyotr G Platonov
Source
J Cardiovasc Electrophysiol. 2015 Feb;26(2):137-41
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adrenergic beta-1 Receptor Antagonists - therapeutic use
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - diagnosis - drug therapy - physiopathology
Calcium Channel Blockers - therapeutic use
Carbazoles - therapeutic use
Cross-Over Studies
Diltiazem - therapeutic use
Electrocardiography, Ambulatory
Female
Heart Conduction System - drug effects - physiopathology
Heart Rate - drug effects
Humans
Male
Metoprolol - therapeutic use
Middle Aged
Norway
Propanolamines - therapeutic use
Time Factors
Treatment Outcome
Verapamil - therapeutic use
Abstract
Irregularity measures have been suggested as risk indicators in patients with atrial fibrillation (AF); however, it is not known to what extent they are affected by commonly used rate-control drugs. We aimed at evaluating the effect of metoprolol, carvedilol, diltiazem, and verapamil on the variability and irregularity of the ventricular response in patients with permanent AF.
Sixty patients with permanent AF were part of an investigator-blind cross-over study, comparing 4 rate-control drugs (diltiazem, verapamil, metoprolol, and carvedilol). We analyzed five 20-minute segments per patient: baseline and the 4 drug regimens. On every segment, heart rate (HR) variability and irregularity of RR series were computed. The variability was assessed as standard deviation, pNN20, pNN50, pNN80, and rMSSD. The irregularity was assessed by regularity index, approximate (ApEn), and sample entropy. A significantly lower HR was obtained with all drugs, the HR was lowest using the calcium channel blockers. All drugs increased the variability of ventricular response in respect to baseline (as an example, rMSSD: baseline 171 ± 47 milliseconds, carvedilol 229 ± 58 milliseconds; P
Notes
Comment In: J Cardiovasc Electrophysiol. 2015 Feb;26(2):142-425431209
PubMed ID
25367150 View in PubMed
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Troponin I levels in permanent atrial fibrillation-impact of rate control and exercise testing.

https://arctichealth.org/en/permalink/ahliterature278212
Source
BMC Cardiovasc Disord. 2016 May 04;16:79
Publication Type
Article
Date
May-04-2016
Author
Anja Wiedswang Horjen
Sara Reinvik Ulimoen
Steve Enger
Jon Norseth
Ingebjørg Seljeflot
Harald Arnesen
Arnljot Tveit
Source
BMC Cardiovasc Disord. 2016 May 04;16:79
Date
May-04-2016
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - blood - diagnosis - drug therapy - physiopathology
Biomarkers - blood
Calcium Channel Blockers - therapeutic use
Carbazoles - therapeutic use
Cross-Over Studies
Diltiazem - therapeutic use
Down-Regulation
Exercise Test
Female
Heart Rate - drug effects
Humans
Male
Metoprolol - therapeutic use
Middle Aged
Norway
Predictive value of tests
Propanolamines - therapeutic use
Treatment Outcome
Troponin I - blood
Troponin T - blood
Verapamil - therapeutic use
Abstract
High-sensitivity troponin I (hs-TnI) and troponin T (hs-TnT) are moderately correlated and independently related to outcome in atrial fibrillation (AF). Rate controlling therapy has been shown to reduce hs-TnT, however the potential impact on hs-TnI levels, and whether this differs from the effects on hs-TnT, has not been investigated previously.
Sixty patients with stable, permanent AF without heart failure or known ischemic heart disease were included in a randomised crossover study (mean age 71 ± 9 years, 18 women). Diltiazem 360 mg, verapamil 240 mg, metoprolol 100 mg, and carvedilol 25 mg were administered once daily for three weeks, in a randomised sequence. At baseline and on the last day of each treatment period, hs-TnI was measured at rest and after a maximal exercise test and compared to hs-TnT.
Hs-TnI and hs-TnT correlated moderately at baseline (rs = 0.582, p
Notes
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PubMed ID
27142292 View in PubMed
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