Document Detail

Effect of diltiazem and metoprolol on left atrial appendix functions in patients with nonvalvular chronic atrial fibrillation.
MedLine Citation:
PMID:  17347074     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Thrombo-embolic events are the important cause of mortality and morbidity in patients with chronic atrial fibrillation (CAF). The origin of thromboembolism is often the left atrial appendix (LAA). Flow rate velocity (FRV) inside the LAA is the major determinant of thrombus formation. The aim of our study was to investigate the effects of diltiazem and metoprolol used for ventricular rate control on FRV of the LAA in CAF patients and thus to evaluate the positive or negative effects of these two drugs on thromboembolic events. METHODS: Sixty-four patients were included in the study. All patients were suffering from CAF for more than a year. The patients were allocated to two groups according with agent used for rate control- metoprolol (Group 1; n=31) and diltiazem (Group 2; n=33). Transesophageal echocardiography was applied to all patients and LAA FRV was measured by a pulse wave Doppler in the 1/3 proximal portion of the LAA. The measurements were repeated after applying 5 mg metoprolol to Group 1 and 25 mg diltiazem to Group 2 via venous cannula. RESULTS: In Group 1 after metoprolol LAA flow velocity changed from 0.25 +/- 0.90 m/s to 0.25 +/- 0.10 m/s (p>0.05). In group 2 after diltiazem left atrial appendix FRV decreased from 0.21 +/- 0.9 m/s to 0.19 +/- 0.6 m/s (p>0.05). CONCLUSIONS: In patients with CAF metoprolol used for ventricular rate control had no effect on LAA flow velocity and the observed decrease in LAA flow rate velocity with intravenous diltiazem was insignificant.
Ilgin Karaca; Naci Coşkun; Mustafa Yavuzkir; Erdoğan Ilkay; Necati Dağli; Ahmet Işik; Mehmet Balin; Mehmet Akbulut; Nadi Arslan
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology     Volume:  7     ISSN:  1302-8723     ISO Abbreviation:  Anadolu Kardiyol Derg     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095069     Medline TA:  Anadolu Kardiyol Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  37-41     Citation Subset:  IM    
Department of Cardiology, Medical School, Firat University, Elaziğ, Turkey.
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MeSH Terms
Adrenergic beta-Antagonists / administration & dosage,  pharmacology,  therapeutic use
Anti-Arrhythmia Agents / administration & dosage,  pharmacology*,  therapeutic use
Atrial Appendage / drug effects*,  physiology,  ultrasonography
Atrial Fibrillation / physiopathology*,  ultrasonography
Atrial Function, Left / drug effects*
Blood Flow Velocity / drug effects
Chronic Disease
Diltiazem / administration & dosage,  pharmacology*,  therapeutic use
Echocardiography, Transesophageal
Infusions, Intravenous
Metoprolol / administration & dosage,  pharmacology*,  therapeutic use
Middle Aged
Thromboembolism / prevention & control
Treatment Outcome
Vasodilator Agents / administration & dosage,  pharmacology,  therapeutic use
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 0/Vasodilator Agents; 37350-58-6/Metoprolol; 42399-41-7/Diltiazem
Comment In:
Anadolu Kardiyol Derg. 2007 Mar;7(1):42-3   [PMID:  17347075 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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