ISSN 2149-2263 | E-ISSN 2149-2271
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Effect of diltiazem and metoprolol on left atrial appendix functions in patients with nonvalvular chronic atrial fibrillation [Anatol J Cardiol]
Anatol J Cardiol. 2007; 7(1): 37-41

Effect of diltiazem and metoprolol on left atrial appendix functions in patients with nonvalvular chronic atrial fibrillation

Ilgın Karaca1, Naci Coşkun2, Mustafa Ferzeyn Yavuzkır1, Erdoğan İlkay4, Necati Dağlı1, Ahmet Işık6, Mehmet Balin2, Mehmet Akbulut7, Nadi Arslan2
1Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
2From Department of Cardiology Medical School, Fırat University, Elazığ, Turkey
3Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
4Department of Cardiology, MESA Hospital, Ankara
5Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
6Department of Rheumatology, Medical School, Fırat University, Elazığ, Turkey
7Fırat Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Elazığ

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.

Keywords: Atrial fibrillation, left atrial appendage, diltiazem, metoprolol

Diltiazem ve metoprololün nonvalvüler kronik atriyal fibrilasyonu olan hastalarda sol atriyal apendiks üzerine etkileri

Ilgın Karaca1, Naci Coşkun2, Mustafa Ferzeyn Yavuzkır1, Erdoğan İlkay4, Necati Dağlı1, Ahmet Işık6, Mehmet Balin2, Mehmet Akbulut7, Nadi Arslan2
1Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
2From Department of Cardiology Medical School, Fırat University, Elazığ, Turkey
3Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
4Department of Cardiology, MESA Hospital, Ankara
5Department of Cardiology, Medical School, Fırat University, Elazığ, Turkey
6Department of Rheumatology, Medical School, Fırat University, Elazığ, Turkey
7Fırat Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Elazığ

Anahtar Kelimeler: Atriyal fibrilasyon, sol atriyal apendiks, diltiazem, metoprolol

Ilgın Karaca, Naci Coşkun, Mustafa Ferzeyn Yavuzkır, Erdoğan İlkay, Necati Dağlı, Ahmet Işık, Mehmet Balin, Mehmet Akbulut, Nadi Arslan. Effect of diltiazem and metoprolol on left atrial appendix functions in patients with nonvalvular chronic atrial fibrillation. Anatol J Cardiol. 2007; 7(1): 37-41
Manuscript Language: English


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Journal Citation Indicator: 0.18
CiteScore: 1.1
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SCImago Journal Rank: 0.348

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