Abstract:
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.
journal_name
Circulationjournal_title
Circulationauthors
Kodama K,Nishigami K,Sakamoto T,Sawamura T,Hirayama T,Misumi H,Nakao Kdoi
10.1161/CIRCULATIONAHA.107.755801subject
Has Abstractpub_date
2008-09-30 00:00:00pages
S167-70issue
14 Suppleissn
0009-7322issn
1524-4539pii
118/14_suppl_1/S167journal_volume
118pub_type
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