Cilostazol decreases total atrial conduction time in patients with peripheral artery disease

Alızade, Elnur; Şahin, Müslüm; Şimşek, Zeki; Açar, Göksel; Bulut, Mehmet; Güler, Ahmet; Avcı, Anıl; Me, Kalkan; Pala, Selçuk; Akçakoyun, Mustafa; Esen, A.M.

doi:10.1177/0267659113513822

Cited by 7 publications

(3 citation statements)

References 42 publications

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“…These are PWD that is an electrocardiographic parameter and AEMD and ACT that are measured by TDI study (13)(14)(15)(16)(17) . In addition, in various contributing factors to develop AF such as obstructive sleep apnoea, diastolic dysfunction, dilated cardiomyopathy and hypertension the prolongation of AEMD during sinus rhythm has been reported (12,(18)(19)(20)(21) . Therefore, increase in AEMD is an electrophysiological marker that predisposes a patient to develop AF.…”

Section: Discussionmentioning

confidence: 99%

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Güler¹

2017

Kosuyolu Heart Journal

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Introduction: AF in patients with mitral stenosis (MS) causes significant morbidity and mortality. PMBV, which is a treatment of choice for patients with MS, is a highly successful procedure that provides significant improvement in symptoms and echocardiographic parameters. In this study we aimed to demonstrate the probable effects of PMBV on novel echocardiographic and electrocardiographic parameters that can predict the development of AF in 1-year period in patients with MS. Patients and Methods:Twenty-eight patients with moderate or severe rheumatic MS (mean age 37.6 ± 7.4 years; 14 (50%) males) were enrolled this study. All patients who were eligible for this procedure underwent comprehensive echocardiographic examinations with evaluation of ACT measured using tissue Doppler imaging (TDI) before PMBW and repeated at the end of the 1 year after successful PMBV. In addition, 12-lead ECGs were recorded for each patient 1 day before PMBV for the evaluation of baseline maximum and minimum P-wave duration and P-wave dispersion (PWD); this was repeated at the end of the 1 year after successful PMBV.Results: ACT (148.1 ± 20.5 vs 121.3 ± 20.5 p< 0.001), P-max (151.7 ± 15.8 vs 137.3 ± 15.6 p< 0.001) and PWD (84.7 ± 18.8 vs 71.1 ± 18.5 p< 0.001) were found to be significantly decreased after PMBV. A strong positive correlation was detected between ACT, P-max, PWD, LAVi ve PAPs before and after PMBV. In addition, there was a strong correlation between Δ values that were measured by subtracting the baseline measurements from the post-PMBV measurements. Accordingly, ΔACT was correlated with ΔP-max ve ΔPWD (r= 0.5 p= 0.007 and r= 0.55 p= 0.002, respectively). ΔACT, ΔP-max and ΔPWD correlated significantly with only ΔLAVi and ΔPAP in echocardiographic parameters. Conclusion:This study demonstrated that atrial conduction properties that have also been evaluated with ECG and TDI studies significantly correlate with other echocardiographic parameters in patients with MS. In addition, significant improvement occurred in these parameters at the end of the 1 year after PMBV. Further prospective investigations may provide useful data for the detection of the relation between atrial electromechanical characteristics and development of AF in patients with MS.Key Words: Rheumatic mitral stenosis; atrial fibrillation; atrial conduction tine P-wave dispersion; percutaneous mitral balloon valvuloplasty Mitral Darlığı Olan Hastalarda Atriyal Elektiriksel ve Elektromekanik Özellikler ÖZETGiriş: Mitral darlığı olan hastalarda atriyal fibrilasyon (AF) önemli bir mortalite ve morbidite nedenidir ve bu hastalarda perkütan mitral balon valvüloplasti (PMBV) semptomlarda ve ekokardiyografik parametrelerde önemli düzelme sağlayan başarılı bir girişimdir. Bu çalışmada mitral darlıklı hastalarda PMBV'nin AF gelişimini predikte edebilen yeni ekokardiyografik ve elektrokardiyografik parametreler üzerindeki bir yıllık dönemdeki etkisinin gösterilmesi amaçlanmıştır. Hastalar ve Yöntem:Orta ve ileri mitral darlığı olan 28 hasta (ortalama yaş 37....

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Section: Discussionmentioning

confidence: 99%

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Güler¹

2017

Kosuyolu Heart Journal

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“…However, it is important to note that the evidence regarding cilostazol and tachyarrhythmia is still limited and unclear. Currently, as we know, there are fewer studies that directly have investigated the effect of cilostazol in AF In a recent study, Alizade et al (36) indicated that cilostazol could decrease total atrial conduction time duration in patients with peripheral artery disease, which may also prevent the development and/or recurrence of AF.…”

Section: Discussionmentioning

confidence: 99%

Cilostazol ameliorates atrial ionic remodeling in long-term rapid atrial pacing dogs

Zhao

Wang³

et al. 2015

Anatol J Cardiol

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Objective:Ionic remodeling has a close correlation with the occurrence of atrial fibrillation (AF). Atrial tachypacing remodeling is associated with characteristic ionic remodeling. The purpose of this study was to assess the efficacy of cilostazol, an oral phosphodiesterase 3 inhibitor, for preventing atrial ionic remodeling in long-term rapid atrial pacing (RAP) dogs.Methods:We use the methods of patch-clamp and molecular biology to investigate the effect of cilostazol on ion channel and channel gene expression in long-term RAP dogs. Twenty-one dogs were randomly assigned to sham, control paced, and paced+cilostazol (5 mg/kg/d, cilo) groups, with 7 dogs in each group. The sham group was instrumented with a pacemaker but without pacing. RAP at 500 beats/min was maintained for 2 weeks in the paced and cilo groups. During the pacing, cilostazol was given orally in the cilo group. Whole-cell patch-clamp technique was used to record atrial L-type Ca2+ (ICaL) and fast sodium channel (INa) ionic currents. Western blot and RT-PCR were applied to estimate the gene expression of the ICaLa) 1C (Cav1.2) and INav1.5a) Nav1.5a) subunits. Statistical analysis was performed using SPSS 13.0.Results:The density of ICaL and INa currents (pA/pF) was significantly reduced in the paced group (ICaL: -6.55±1.42 vs. -4.46±0.59 pA/pF; INa: -48.24±10.54 vs. -30.48±5.20 pA/pF, p<0.01). The paced+cilo group could not increase the density of ICaL currents (ICaL: -4.37±1.25 pA/pF, p>0.05], while the INa currents were recovered (-44.54±12.65 pA/pF, p<0.01) compared with the paced group. The mRNA and protein expression levels of Cav1.2 and Nav1.5a were apparently down-regulated in the paced group (p<0.01), but after cilostazol treatment, both of these subunits were up-regulated significantly (p<0.01).Conclusion:Cilostazol may have protective effects on RAP-induced atrial ionic remodeling.

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“…Cilostazol is used for the effective treatment of intermittent claudication, which is a chronic arterial occlusive disease in clinical practice. Alizade et al [18] showed that cilostazol decreased the duration of the total atrial conduction time in patients with peripheral artery disease, and cilostazol may also prevent the development and/or recurrence of AF. However, the potential mechanisms of cilostazol treatment remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Cilostazol Prevents Atrial Structural Remodeling through the MEK/ERK Pathway in a Canine Model of Atrial Tachycardia

Zhao

Wang²,

Chen³

et al. 2016

Cardiology

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Objectives: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. Atrial structural remodeling (ASR), particularly atrial fibrosis, is an important contributor to the AF substrate. This study aimed to investigate the preventive effects of the phosphodiesterase 3 inhibitor cilostazol on ASR and its potential molecular mechanisms in a canine model of rapid atrial pacing (RAP). Methods: Thirty dogs were assigned to sham (Sham), paced/ no treatment (Paced) and paced + cilostazol 5 mg/kg/day (Paced + cilo) groups, with 10 dogs in each group. RAP at 500 beats/min was maintained for 2 weeks, while the Sham group was instrumented without pacing. Cilostazol was provided orally during pacing. Western blotting, RT-PCR and pathology were used to assess ASR. Results: Cilostazol attenuated atrial interstitial fibrosis and structural remodeling in canines with RAP. MEK/ERK transduction pathway gene expression was upregulated in the Paced group compared with the Sham group. Cilostazol markedly alleviated these changes in the MEK/ERK pathway. Transforming growth factor-β₁ protein expression in the Paced group was significantly higher than in the Sham group (p < 0.01), and was significantly reduced by cilostazol (p < 0.01). Conclusions: Our findings suggest that cilostazol is beneficial for prevention and treatment in atrial tachycardia-induced ASR in a canine model of RAP.

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Cilostazol decreases total atrial conduction time in patients with peripheral artery disease

Abstract: Our results showed that 200 mg cilostazol treatment decreased TACT duration in patients with peripheral artery disease, which may also prevent the development and/or recurrence of atrial fibrillation (AF).

Cited by 7 publications

References 42 publications

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Atrial Electrical and Electromechanical Characteristics in Patients with Rheumatic Mitral Stenosis

Cilostazol ameliorates atrial ionic remodeling in long-term rapid atrial pacing dogs

Cilostazol Prevents Atrial Structural Remodeling through the MEK/ERK Pathway in a Canine Model of Atrial Tachycardia

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