Effects of angiotensin II type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation
Koichiro Kumagai, MD*,*,
Hideko Nakashima, MD*,
Hidenori Urata, MD*,
Naoki Gondo, MD*,
Kikuo Arakawa, MD, FACC* and
Keijiro Saku, MD, FACC*
* Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka, Japan
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Figure 1 Time course of the percent changes in the atrial effective refractory period (AERP) of the right atrial appendage and intra-atrial conduction time (CT) from the right atrial appendage to the lower right atrial wall at a basic cycle length of 300 ms, and the mean duration of induced atrial fibrillation (AF) in the control (white circles, white bars) and candesartan (black circles, black bars) groups. The degree of AERP shortening was similar between the two groups, the intra-atrial CT in the candesartan group was significantly shorter than that in the control group, and the mean AF duration in the candesartan group was significantly shorter than that in the control group.  p < 0.01, *p < 0.05 compared with the control group.
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Figure 2 Representative histologic sections of the right atrial free wall from each group (Masson trichrome stain) from a sham dog (A), a fifth week rapid pacing dog (B), and a fifth week rapid pacing with candesartan treated dog (C). In the sham dog, the intracellular space appeared normal. In the control dog, extensive interstitial fibrosis, evidenced by Masson trichrome stain, was found. In the candesartan treated dog, interstitial fibrosis was attenuated. Magnification: x400.
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Figure 3 The percentage of fibrosis of the free walls and appendages in both atria after five weeks of pacing. The percentage of fibrosis in all atrial regions in the candesartan group was markedly lower than that in the control, although greater than that in the sham group. Hatched bars = sham group; white bars = control group; black bars = candesartan group.  p < 0.001 compared with the control group. *p < 0.05 compared with the sham group. RAA = right atrial appendage; RAFW = right atrial free wall; LAA = left atrial appendage; LAFW = left atrial free wall.
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