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본태성 고혈압 환자에서 심장의 전기적인 안정성에 대한 스타틴의 효과
김성수 ( Sung Soo Kim ),장수영 ( Soo Young Jang ),고점석 ( Jeom Seok Ko ),윤남식 ( Nam Sik Yoon ),김계훈 ( Ke Hun Kim ),박형욱 ( Hyung Wook Park ),홍영준 ( Young Joon Hong ),김주한 ( Ju Han Kim ),안영근 ( Young Keun Ahn ),정명호 ( 대한내과학회 2010 대한내과학회지 Vol.78 No.3
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). Results: There was no significant difference in the clinical characteristics of the patients with and without statins. After antihypertensive therapy for 1 year, the P wave dispersion, high-frequency low-amplitude (HFLA) signals in the QRS complex of less than 40 μV, and T peak-to-end dispersion were increased significantly (p<0.001, p<0.05, and p<0.01, respectively) in the patients who were not taking statins, while these changes were not seen in the statin group. 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 in-homogeneity in atrial refractoriness and conduction disturbance. (Korean J Med 78:325-332, 2010)
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