The effects of valsartan on paroxysmal atrial fibrillation combining hypertension and its mechanism

Objective To investigate the impact of valsartan on the recurrent rate of paroxysmal atrial fibrillation and the incidence of persistent atrial fibrillation after cardioversion of atrial fibrillation,and the serum levels of hypersensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6),tumor necrosis factor-alpha (TNF-α),atrial natriuretic peptide (ANP) and left atrial diameter (LAD) in patients with hypertension complicated paroxysmal atrial fibrillation,and explore the effects and mechanisms of anti-atrial fibrillation of valsartan.Methods Consecutive 90 patients with hypertension complicated incipient paroxysmal atrial fibrillation between October 2007 and October 2009 were recruited in this study.The patients were randomly divided into treatment group and control group (n=45 each).On top of conventional therapy,valsartan and nifedipine controlled release tablets were respectively used for antihypertensive therapy in treatment group and control group.Treatment period was one year.The recurrent rate of atrial fibrillation and incidence of persistent atrial fibrillation after cardioversion of incipient paroxysmal atrial fibrillation were observed,and the changes of hs-CRP,IL-6,TNF-α,ANP and LAD before and after treatment were determined.Results After treatment,compared with control group,the incidences of atrial fibrillation relapse and transformed as persistent atrial fibrillation in treatment group had declining tendency〔15.6% (7 /45) vs 31.1% (14 /45),4.4% (2/45) vs 11.1%(5/45) 〕,despite there was no significance,and the levels of hs-CRP,IL-6,TNF-α,ANP and LAD in treatment group were markedly lowered (all P 0.05).Conclusions Valsartan could decrease the levels of inflammatory factors and ANP and reduce LAD,and it has tendency of declining recurrent rate of paroxysmal atrial fibrillation and incidence of persistent atrial fibrillation.