| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2000;101:2612.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Angiotensin II Antagonist Prevents Electrical Remodeling in Atrial Fibrillation
From the Second Department of Internal Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan.
Correspondence to Koichiro Kumagai, MD, Second Department of Internal Medicine, School of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180 Japan. E-mail kxk{at}fukuoka-u.ac.jp
Background—The blockade of angiotensin II (Ang II) formation has protective effects on cardiovascular tissue; however, the role of Ang II in atrial electrical remodeling is unknown. The purpose of this study was to investigate the effects of candesartan and captopril on atrial electrical remodeling.
Methods and Results—In 24 dogs, the atrial effective refractory period (AERP) was measured before, during, and after rapid atrial pacing. Rapid atrial pacing at 800 bpm was maintained for 180 minutes. The infusion of saline (n=8), candesartan (n=5), captopril (n=6), or Ang II (n=5) was initiated 30 minutes before rapid pacing and continued throughout the study. In the saline group, AERP was significantly shortened during rapid atrial pacing (from 149±11 to 132±16 ms, P<0.01). There was no significant difference in AERP shortening between the saline group and the Ang II group. However, in the candesartan and captopril groups, shortening of the AERP after rapid pacing was completely inhibited (from 142±9 to 147±12 ms with candesartan, from 153±15 to 153±14 ms with captopril, P=NS). Although rate adaptation of the AERP was lost in the saline group, this phenomenon was preserved in the candesartan and captopril groups.
Conclusions—The inhibition of endogenous Ang II prevented AERP shortening during rapid atrial pacing. These results indicate for the first time that Ang II may be involved in the mechanism of atrial electrical remodeling and that the blockade of Ang II may lead to the better therapeutic management of human atrial fibrillation.
Key Words: angiotensin • fibrillation • remodeling
This article has been cited by other articles:
 |
|
 |
|
  S. K. Kim, H.-N. Pak, J. H. Park, K. J. Ko, J. S. Lee, J. I. Choi, D. H. Choi, and Y.-H. Kim Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion Europace, December 1, 2009; 11(12): 1632 - 1638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Hegbom, A. Tveit, I. Grundvold, H. Arnesen, and P. Smith Effects of angiotensin receptor blockade on serial P-wave signal-averaged electrocardiograms after electrical cardioversion of persistent atrial fibrillation Europace, October 1, 2009; 11(10): 1301 - 1307. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-K. Wu, C.-D. Tseng, Y.-T. Huang, C.-S. Hsieh, W.-S. Tsai, J.-L. Lin, F.-T. Chiang, and C.-T. Tsai Angiotensin II does not influence expression of sarcoplasmic reticulum Ca2 + ATPase in atrial myocytes Journal of Renin-Angiotensin-Aldosterone System, September 1, 2009; 10(3): 121 - 126. [Abstract] [PDF]
|
|
|
|
 |
|
 M. A. Crandall, D. J. Bradley, D. L. Packer, and S. J. Asirvatham Contemporary Management of Atrial Fibrillation: Update on Anticoagulation and Invasive Management Strategies Mayo Clin. Proc., July 1, 2009; 84(7): 643 - 662. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Ozben, M. Sumerkan, A. M. Tanrikulu, N. Papila-Topal, A. S. Fak, and A. Toprak Perindopril decreases P wave dispersion in patients with stage 1 hypertension Journal of Renin-Angiotensin-Aldosterone System, June 1, 2009; 10(2): 85 - 90. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Armario and A. de la Sierra Antihypertensive treatment and stroke prevention: are angiotensin receptor blockers superior to other antihypertensive agents? Therapeutic Advances in Cardiovascular Disease, June 1, 2009; 3(3): 197 - 204. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Belluzzi, L. Sernesi, P. Preti, F. Salinaro, M. L. Fonte, and S. Perlini Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients. J. Am. Coll. Cardiol., January 6, 2009; 53(1): 24 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. von Lewinski, J. Kockskamper, S.-U. Rubertus, D. Zhu, J. D. Schmitto, F. A. Schondube, G. Hasenfuss, and B. Pieske Direct pro-arrhythmogenic effects of angiotensin II can be suppressed by AT1 receptor blockade in human atrial myocardium Eur J Heart Fail, December 1, 2008; 10(12): 1172 - 1176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Laszlo, C. Eick, N. Rueb, S. Weretka, H.-J. Weig, J. Schreieck, and R. F Bosch Inhibition of the renin-angiotensin system: effects on tachycardia-induced early electrical remodelling in rabbit atrium Journal of Renin-Angiotensin-Aldosterone System, September 1, 2008; 9(3): 125 - 132. [Abstract] [PDF]
|
|
|
|
|
|
J. L. Serra and M. Bendersky Review: Atrial fibrillation and renin-angiotensin system Therapeutic Advances in Cardiovascular Disease, June 1, 2008; 2(3): 215 - 223. [Abstract] [PDF]
|
|
|
|
|
|
J. R. Ehrlich, P. Biliczki, S. H. Hohnloser, and S. Nattel Atrial-Selective Approaches for the Treatment of Atrial Fibrillation J. Am. Coll. Cardiol., February 26, 2008; 51(8): 787 - 792. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Goette, A. Bukowska, U. Lendeckel, M. Erxleben, M. Hammwohner, D. Strugala, J. Pfeiffenberger, F.-W. Rohl, C. Huth, M. P.A. Ebert, et al. Angiotensin II Receptor Blockade Reduces Tachycardia-Induced Atrial Adhesion Molecule Expression Circulation, February 12, 2008; 117(6): 732 - 742. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Goette and U. Lendeckel Electrophysiological effects of angiotensin II. Part I: signal transduction and basic electrophysiological mechanisms Europace, February 1, 2008; 10(2): 238 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Casaclang-Verzosa, B. J. Gersh, and T. S.M. Tsang Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J. Am. Coll. Cardiol., January 1, 2008; 51(1): 1 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. T. Issac, H. Dokainish, and N. M. Lakkis Role of Inflammation in Initiation and Perpetuation of Atrial Fibrillation: A Systematic Review of the Published Data J. Am. Coll. Cardiol., November 20, 2007; 50(21): 2021 - 2028. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sakabe, A. Shiroshita-Takeshita, A. Maguy, C. Dumesnil, A. Nigam, T.-K. Leung, and S. Nattel Omega-3 Polyunsaturated Fatty Acids Prevent Atrial Fibrillation Associated With Heart Failure but Not Atrial Tachycardia Remodeling Circulation, November 6, 2007; 116(19): 2101 - 2109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-T. Tsai, D. L. Wang, W.-P. Chen, J.-J. Hwang, C.-S. Hsieh, K.-L. Hsu, C.-D. Tseng, L.-P. Lai, Y.-Z. Tseng, F.-T. Chiang, et al. Angiotensin II Increases Expression of {alpha}1C Subunit of L-Type Calcium Channel Through a Reactive Oxygen Species and cAMP Response Element-Binding Protein-Dependent Pathway in HL-1 Myocytes Circ. Res., May 25, 2007; 100(10): 1476 - 1485. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nattel, A. Maguy, S. Le Bouter, and Y.-H. Yeh Arrhythmogenic Ion-Channel Remodeling in the Heart: Heart Failure, Myocardial Infarction, and Atrial Fibrillation Physiol Rev, April 1, 2007; 87(2): 425 - 456. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Zankov, M. Omatsu-Kanbe, F. Toyoda, W.-G. Ding, H. Matsuura, T. Isono, and M. Horie Response to Letter Regarding Article, "Angiotensin II Potentiates the Slow Component of Delayed Rectifier K+ Current via the AT1 Receptor in Guinea Pig Atrial Myocytes" Circulation, October 31, 2006; 114(18): e566 - e566. [Full Text] [PDF]
|
|
|
|
|
|
B. Williams The Year in Hypertension J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1698 - 1711. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Dagres, G. Karatasakis, F. Panou, G. Athanassopoulos, T. Maounis, E. Tsougos, K. Kourea, I. Malakos, D. Th. Kremastinos, and D. V. Cokkinos Pre-treatment with Irbesartan attenuates left atrial stunning after electrical cardioversion of atrial fibrillation Eur. Heart J., September 1, 2006; 27(17): 2062 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Yin, D. Dalal, Z. Liu, J. Wu, D. Liu, X. Lan, Y. Dai, L. Su, Z. Ling, Q. She, et al. Prospective randomized study comparing amiodarone vs. amiodarone plus losartan vs. amiodarone plus perindopril for the prevention of atrial fibrillation recurrence in patients with lone paroxysmal atrial fibrillation Eur. Heart J., August 1, 2006; 27(15): 1841 - 1846. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Shimoni, D. Hunt, K. Chen, T. Emmett, and G. Kargacin Differential autocrine modulation of atrial and ventricular potassium currents and of oxidative stress in diabetic rats Am J Physiol Heart Circ Physiol, May 1, 2006; 290(5): H1879 - H1888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Zankov, M. Omatsu-Kanbe, T. Isono, F. Toyoda, W.-G. Ding, H. Matsuura, and M. Horie Angiotensin II Potentiates the Slow Component of Delayed Rectifier K+ Current via the AT1 Receptor in Guinea Pig Atrial Myocytes Circulation, March 14, 2006; 113(10): 1278 - 1286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Ehrlich, S. H. Hohnloser, and S. Nattel Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence Eur. Heart J., March 1, 2006; 27(5): 512 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Kalus, C. I. Coleman, and C. M. White The Impact of Suppressing the Renin-Angiotensin System on Atrial Fibrillation J. Clin. Pharmacol., January 1, 2006; 46(1): 21 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D.M. Engelmann and J. H. Svendsen Inflammation in the genesis and perpetuation of atrial fibrillation Eur. Heart J., October 2, 2005; 26(20): 2083 - 2092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Milliez, N. DeAngelis, C. Rucker-Martin, A. Leenhardt, E. Vicaut, E. Robidel, P. Beaufils, C. Delcayre, and S. N. Hatem Spironolactone reduces fibrosis of dilated atria during heart failure in rats with myocardial infarction Eur. Heart J., October 2, 2005; 26(20): 2193 - 2199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O Wazni, D O Martin, N F Marrouche, M Shaaraoui, M K Chung, S Almahameed, R A Schweikert, W I Saliba, and A Natale C reactive protein concentration and recurrence of atrial fibrillation after electrical cardioversion Heart, October 1, 2005; 91(10): 1303 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Healey, A. Baranchuk, E. Crystal, C. A. Morillo, M. Garfinkle, S. Yusuf, and S. J. Connolly Prevention of Atrial Fibrillation With Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Meta-Analysis J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1832 - 1839. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-C. Tardif, P. L. L'Allier, P.-F. Keller, and A. Ducharme Reduced atrial fibrillation incidence by angiotensin-converting enzyme inhibitors: A possible contributing mechanism: Reply J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1144 - 1144. [Full Text] [PDF]
|
|
|
|
|
|
K. Wachtell, M. Lehto, E. Gerdts, M. H. Olsen, B. Hornestam, B. Dahlof, H. Ibsen, S. Julius, S. E. Kjeldsen, L. H. Lindholm, et al. Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: The Losartan Intervention For End point reduction in hypertension (LIFE) study J. Am. Coll. Cardiol., March 1, 2005; 45(5): 712 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Kistler, N. C. Davidson, P. Sanders, S. P. Fynn, I. H. Stevenson, S. J. Spence, J. K. Vohra, P. B. Sparks, and J. M. Kalman Absence of acute effects of angiotensin II on atrial electrophysiology in humans J. Am. Coll. Cardiol., January 4, 2005; 45(1): 154 - 156. [Full Text] [PDF]
|
|
|
|
|
|
A. H Madrid, I. M. Marin, C. Escobar Cervantes, E. Bernal Morell, J. Escudero Estevez, G. Moreno, J. Rondon Parajon, Jian Peng, L. Limon, S. Nannini, et al. Prevention of recurrences in patients with lone atrial fibrillation. The dose-dependent effect of angiotensin II receptor blockers Journal of Renin-Angiotensin-Aldosterone System, September 1, 2004; 5(3): 114 - 120. [Abstract] [PDF]
|
|
|
|
|
|
P. L. L'Allier, A. Ducharme, P.-F. Keller, H. Yu, M.-C. Guertin, and J.-C. Tardif Angiotensin-converting enzyme inhibition in hypertensive patients is associated with a reduction in the occurrence of atrial fibrillation J. Am. Coll. Cardiol., July 7, 2004; 44(1): 159 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Boldt, J. Garbade, J. F. Gummert, and S. Dhein Reply J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2363 - 2364. [Full Text] [PDF]
|
|
|
|
|
|
C.-T. Tsai, L.-P. Lai, J.-L. Lin, F.-T. Chiang, J.-J. Hwang, M. D. Ritchie, J. H. Moore, K.-L. Hsu, C.-D. Tseng, C.-S. Liau, et al. Renin-Angiotensin System Gene Polymorphisms and Atrial Fibrillation Circulation, April 6, 2004; 109(13): 1640 - 1646. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Nakano, S. Niida, K. Dote, S. Takenaka, H. Hirao, F. Miura, M. Ishida, T. Shingu, T. Sueda, M. Yoshizumi, et al. Matrix metalloproteinase-9 contributes to human atrial remodeling during atrial fibrillation J. Am. Coll. Cardiol., March 3, 2004; 43(5): 818 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R.J. Shelton, G.C. Kaye, and J.G.F. Cleland Controlling persistent atrial fibrillation QJM, March 1, 2004; 97(3): 179 - 180. [Full Text] [PDF]
|
|
|
|
|
|
K.-C. Ueng, T.-P. Tsai, W.-C. Yu, C.-F. Tsai, M.-C. Lin, K.-C. Chan, C.-Y. Chen, D.-J. Wu, C.-S. Lin, and S.-A. Chen Use of enalapril to facilitate sinus rhythm maintenance after external cardioversion of long-standing persistent atrial fibrillation: Results of a prospective and controlled study Eur. Heart J., December 1, 2003; 24(23): 2090 - 2098. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Boldt, U. Wetzel, J. Weigl, J. Garbade, J. Lauschke, G. Hindricks, H. Kottkamp, J. F. Gummert, and S. Dhein Expression of angiotensin II receptors in human left and right atrial tissue in atrial fibrillation with and without underlying mitral valve disease J. Am. Coll. Cardiol., November 19, 2003; 42(10): 1785 - 1792. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.L. Botto, M. Luzi, and A. Sagone Atrial fibrillation: the remodelling phenomenon Eur. Heart J. Suppl., September 1, 2003; 5(suppl_H): H1 - H7. [Abstract] [PDF]
|
|
|
|
|
|
K. Kumagai, H. Nakashima, H. Urata, N. Gondo, K. Arakawa, and K. Saku Effects of angiotensin II type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2197 - 2204. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Vermes, J.-C. Tardif, M. G. Bourassa, N. Racine, S. Levesque, M. White, P. G. Guerra, and A. Ducharme Enalapril Decreases the Incidence of Atrial Fibrillation in Patients With Left Ventricular Dysfunction: Insight From the Studies Of Left Ventricular Dysfunction (SOLVD) Trials Circulation, June 17, 2003; 107(23): 2926 - 2931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Shinagawa, A. Shiroshita-Takeshita, G. Schram, and S. Nattel Effects of Antiarrhythmic Drugs on Fibrillation in the Remodeled Atrium: Insights Into the Mechanism of the Superior Efficacy of Amiodarone Circulation, March 18, 2003; 107(10): 1440 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Savelieva and A. John Camm Atrial fibrillation and heart failure: natural history and pharmacological treatment Europace, January 1, 2003; 5(s1): S5 - S19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Madrid, M. G. Bueno, J. M.G. Rebollo, I. Marin, G. Pena, E. Bernal, A. Rodriguez, L. Cano, J. M. Cano, P. Cabeza, et al. Use of Irbesartan to Maintain Sinus Rhythm in Patients With Long-Lasting Persistent Atrial Fibrillation: A Prospective and Randomized Study Circulation, July 16, 2002; 106(3): 331 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nattel, M. Allessie, and M. Haissaguerre Spotlight on atrial fibrillation--the 'complete arrhythmia' Cardiovasc Res, May 1, 2002; 54(2): 197 - 203. [Full Text] [PDF]
|
|
|
|
|
|
A. Goette, U. Lendeckel, and H. U Klein Signal transduction systems and atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 247 - 258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. J.J.M. Brundel, R. H. Henning, H. H. Kampinga, I. C. Van Gelder, and H. J.G.M. Crijns Molecular mechanisms of remodeling in human atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 315 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Nattel Therapeutic implications of atrial fibrillation mechanisms: can mechanistic insights be used to improve AF management? Cardiovasc Res, May 1, 2002; 54(2): 347 - 360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Shinagawa, H. Mitamura, S. Ogawa, and S. Nattel Effects of inhibiting Na+/H+-exchange or angiotensin converting enzyme on atrial tachycardia-induced remodeling Cardiovasc Res, May 1, 2002; 54(2): 438 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Korte, M. Niehaus, G. Borchert, and J. Tebbenjohanns Significant prolongation of atrial monophasic action potential duration: short-term reverse electrophysiological changes after internal cardioversion of atrial fibrillation Cardiovasc Res, March 1, 2002; 53(4): 944 - 951. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Caballero, E. Delpón, C. Valenzuela, M. Longobardo, T. González, and J. Tamargo Direct Effects of Candesartan and Eprosartan on Human Cloned Potassium Channels Involved in Cardiac Repolarization Mol. Pharmacol., April 1, 2001; 59(4): 825 - 836. [Abstract] [Full Text]
|
|
|
|
|
|
S. Nattel and D. Li Ionic Remodeling in the Heart : Pathophysiological Significance and New Therapeutic Opportunities for Atrial Fibrillation Circ. Res., September 15, 2000; 87(6): 440 - 447. [Abstract] [Full Text] [PDF]
|
|