Key result
Six months of sotalol therapy in patients with stage II hypertension and frequent extrasystole significantly reduced left ventricular mass index by 19.5% and increased ejection fraction by 8.5%.
Why the study?
Many antiarrhythmic drugs carry proarrhythmic risks, warranting evaluation of sotalol's effects on myocardial morphofunctional parameters in patients with hypertension and extrasystole.
Does sotalol improve left ventricular structural and geometric remodeling in patients with stage II hypertension and extrasystole?
Cohort (n=150)
No
Does sotalol improve left ventricular structural and geometric remodeling in patients with stage II hypertension and extrasystole?
Sotalol may provide beneficial anti-remodeling effects on the left ventricle alongside its antiarrhythmic efficacy in patients with stage II hypertension and extrasystole.
Annotation. The spread of hypertension in the world encourages the search for new methods for its diagnosis and treatment. And the problem of treating patients with cardiac arrhythmias is that antiarrhythmic drugs of various classes used by doctors of practical health care have proarrhythmogenic properties. And this increases the possibility of the development of lethal cardiovascular events. From this perspective, the parameters for the effect on the morphofunctional parameters of the myocardium, highlighted in this article, when using the antiarrhythmic drug III sotalol, which has the properties of a beta-blocker, are relevant and justified. The purpose of the study was to study the effect of sotalol on the morphological and functional parameters of the myocardium with a combination of stage II hypertension and extrasystole of various topics in patients of different age groups and gender content. We examined 120 people with stage II hypertension (42 men and 78 women) aged 27 to 81 years (average age 59.8 years) and extrasystole of various topics and 30 people (13 men and 17 women) aged 30 to 76 years old (average age — 56.4) with stage II hypertension, in accordance with the Recommendations of the Ukrainian Association of Cardiology, without signs of extrasystole. The first clinical group was formed by 54 (45%) patients with supraventricular extrasystoles, the second — 42 (35%) patients with ventricular extrasystoles, the third — 24 (20%) with combined supraventricular and ventricular extrasystoles. Statistical analysis of the results of the study was performed using methods of variational statistics using the programs MicroSoft Exel 2003 and StatSoft “Statistica” v. 10.0. The regularities of such indicators of structural and geometric remodeling of the left ventricle in patients with isolated hypertension, hypertension and extrasystole of various topics, the nature of remodeling of the left ventricle, analysis of changes in intracardiac hemodynamics over 6 months of taking sotalol by the above-mentioned patients are established. It was established that in patients with hypertension and with hypertension and supraventricular extrasystole concentric hypertrophy of the left ventricle predominates, in patients with hypertension and ventricular extrasystole eccentric remodeling, in patients with hypertension and combined extrasystole, is eccentric concentric remodeling of the left ventricle. It was established that the anti-remodeling effect of sotalol was reflected in the effect on the structural-geometric state of the left ventricle, and the analysis of the antiarrhythmic efficacy of sotalol allows us to recommend it as a basic treatment for patients with hypertension combined with extrasystole. The results demonstrated the effect of sotalol on the structural and functional state of the myocardium in patients with isolated hypertension and hypertension, combined with extrasystole.
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Іvanov et al. (2020) conducted a cohort in Hypertension stage II with extrasystole (n=150). Sotalol vs. Baseline was evaluated on Left ventricular mass index (iMMLV) (-19.5% reduction, p=<0.01). Six months of sotalol therapy in patients with stage II hypertension and frequent extrasystole significantly reduced left ventricular mass index by 19.5% and increased ejection fraction by 8.5%.
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