Document Detail


Tight heart rate control reduces secondary adverse events in patients with type B acute aortic dissection.
MedLine Citation:
PMID:  18824750     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although type B aortic dissection has been treated with beta blockers to lower the arterial blood pressure (BP), there has been little evidences about reduction in heart rate (HR). We assessed whether tight HR control improved the outcome of medical treatment in patients with aortic dissection. METHODS AND RESULTS: From 1997 to 2005, 171 patients with acute aortic dissection medically treated and controlled to lower BP under 120 mm Hg were enrolled. Based on the average HR at 3, 5, and 7 days after the onset, patients were divided into tight HR (<60 beat per minute) control group (32 patients; mean HR of 56.6+/-3.1 beat per minute) and conventional HR (>/=60 beat per minute) control group (139 patients; mean HR of 71.7+/-8.2 beat per minute). We compared the frequency of aortic events including late organ or limb ischemia, aortic rupture, recurrent dissection, and aortic expansion of >5 mm, and surgical requirement between two groups. During a median follow-up of 27.0 months, late organ or limb ischemia, aortic rupture, recurrent dissection, pathological aortic expansion, and aortic surgery occurred in 0, 8, 14, 39, and 26 patients, respectively. Reduction in aortic events was observed in tight HR control group (12.5%) compared to conventional HR control group (36.0%), (Odds ratio: 0.25, C.I.: 0.08 to 0.77, P<0.01). CONCLUSIONS: The present study demonstrated that tight heart rate control improved the outcome of medical treatment in patients with aortic dissection.
Authors:
Kazuhisa Kodama; Kazuhiro Nishigami; Tomohiro Sakamoto; Tadashi Sawamura; Touitsu Hirayama; Hiroyasu Misumi; Koichi Nakao
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  118     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-30     Completed Date:  2008-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S167-70     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami, Kumamoto 861-4193, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adrenergic beta-Antagonists / therapeutic use*
Aneurysm, Dissecting / complications,  drug therapy*,  physiopathology*
Antihypertensive Agents / therapeutic use*
Aorta / surgery
Aortic Aneurysm / complications,  drug therapy*,  physiopathology
Aortic Rupture / epidemiology,  etiology
Blood Pressure / drug effects
Extremities / blood supply
Follow-Up Studies
Heart Rate*
Humans
Incidence
Ischemia / etiology
Recurrence
Treatment Outcome
Vascular Surgical Procedures
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents

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