Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy

Background: Current treatment guidelines for arrhythmogenic right ventricular cardiomyopathy (ARVC) mainly emphasize on prevention of ventricular arrhythmic events. Despite the progressive nature of ARVC, therapeutic options focusing on decelerating disease progression are scarce.Methods and Results...

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Autores principales:	Bin Tu, Lingmin Wu, Lihui Zheng, Shangyu Liu, Lishui Sheng, Limin Liu, Zhenghui Zhu, Yan Yao
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	angiotensin-converting enzyme inhibitors arrhythmogenic right ventricular cardiomyopathy anti-arrhythmic drug ventricular arrhythmia disease progression Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/83e4375c2c1444a3a25151da276ac3f6
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spelling	oai:doaj.org-article:83e4375c2c1444a3a25151da276ac3f62021-11-12T04:53:17ZAngiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy2297-055X10.3389/fcvm.2021.769138https://doaj.org/article/83e4375c2c1444a3a25151da276ac3f62021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.769138/fullhttps://doaj.org/toc/2297-055XBackground: Current treatment guidelines for arrhythmogenic right ventricular cardiomyopathy (ARVC) mainly emphasize on prevention of ventricular arrhythmic events. Despite the progressive nature of ARVC, therapeutic options focusing on decelerating disease progression are scarce.Methods and Results: This retrospective observational cohort study included 311 patients [age, 39.1 ± 14.4 years; male, 233 (74.9%)] with a definite diagnosis of ARVC as determined by the 2010 Task Force Diagnostic Criteria. Among them, 113 patients (36.3%) received ACEI/ARB treatment. Disease progression was evaluated according to repeat transthoracic echocardiograms with a linear mixed model. Patients receiving ACEI/ARB treatment were associated with slower disease progression reflected by a gradual decrease in tricuspid annular plane systolic excursion than those not receiving ACEI/ARB treatment (0.37 vs. 0.61 mm per year decrease, P < 0.001) and slower dilation of right ventricular outflow tract (0.57 vs. 1.06 mm per year increased, P = 0.003). Cox proportional hazard regression models were used to evaluate the association between life-threatening ventricular tachycardia events and ACEI/ARB treatment. A reduced risk of life-threatening ventricular arrhythmia was associated with ACEI/ARB treatment compared to that without ACEI/ARB treatment (adjusted HR: 0.71, 95% CI: 0.52–0.96, P = 0.031).Conclusions: ACEI/ARB treatment is associated with slower disease progression and lower risk of life-threatening ventricular arrhythmia in patients with ARVC. Delaying disease progression may pave way for reducing life-threatening ventricular arrhythmia risk.Bin TuLingmin WuLihui ZhengShangyu LiuLishui ShengLimin LiuZhenghui ZhuYan YaoFrontiers Media S.A.articleangiotensin-converting enzyme inhibitorsarrhythmogenic right ventricular cardiomyopathyanti-arrhythmic drugventricular arrhythmiadisease progressionDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	angiotensin-converting enzyme inhibitors arrhythmogenic right ventricular cardiomyopathy anti-arrhythmic drug ventricular arrhythmia disease progression Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	angiotensin-converting enzyme inhibitors arrhythmogenic right ventricular cardiomyopathy anti-arrhythmic drug ventricular arrhythmia disease progression Diseases of the circulatory (Cardiovascular) system RC666-701 Bin Tu Lingmin Wu Lihui Zheng Shangyu Liu Lishui Sheng Limin Liu Zhenghui Zhu Yan Yao Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
description	Background: Current treatment guidelines for arrhythmogenic right ventricular cardiomyopathy (ARVC) mainly emphasize on prevention of ventricular arrhythmic events. Despite the progressive nature of ARVC, therapeutic options focusing on decelerating disease progression are scarce.Methods and Results: This retrospective observational cohort study included 311 patients [age, 39.1 ± 14.4 years; male, 233 (74.9%)] with a definite diagnosis of ARVC as determined by the 2010 Task Force Diagnostic Criteria. Among them, 113 patients (36.3%) received ACEI/ARB treatment. Disease progression was evaluated according to repeat transthoracic echocardiograms with a linear mixed model. Patients receiving ACEI/ARB treatment were associated with slower disease progression reflected by a gradual decrease in tricuspid annular plane systolic excursion than those not receiving ACEI/ARB treatment (0.37 vs. 0.61 mm per year decrease, P < 0.001) and slower dilation of right ventricular outflow tract (0.57 vs. 1.06 mm per year increased, P = 0.003). Cox proportional hazard regression models were used to evaluate the association between life-threatening ventricular tachycardia events and ACEI/ARB treatment. A reduced risk of life-threatening ventricular arrhythmia was associated with ACEI/ARB treatment compared to that without ACEI/ARB treatment (adjusted HR: 0.71, 95% CI: 0.52–0.96, P = 0.031).Conclusions: ACEI/ARB treatment is associated with slower disease progression and lower risk of life-threatening ventricular arrhythmia in patients with ARVC. Delaying disease progression may pave way for reducing life-threatening ventricular arrhythmia risk.
format	article
author	Bin Tu Lingmin Wu Lihui Zheng Shangyu Liu Lishui Sheng Limin Liu Zhenghui Zhu Yan Yao
author_facet	Bin Tu Lingmin Wu Lihui Zheng Shangyu Liu Lishui Sheng Limin Liu Zhenghui Zhu Yan Yao
author_sort	Bin Tu
title	Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
title_short	Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
title_full	Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
title_fullStr	Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
title_full_unstemmed	Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy
title_sort	angiotensin-converting enzyme inhibitors/angiotensin receptor blockers: anti-arrhythmic drug for arrhythmogenic right ventricular cardiomyopathy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/83e4375c2c1444a3a25151da276ac3f6
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Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers: Anti-arrhythmic Drug for Arrhythmogenic Right Ventricular Cardiomyopathy

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