{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:34:54Z","timestamp":1778740494631,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T00:00:00Z","timestamp":1506124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Eplerenone is reported to reduce the development of atrial fibrillation (AF). The aim of this study was to clarify the mechanism of eplerenone for AF prevention from the viewpoint of P wave morphology, which is reported to correlate with atrial fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010five patients with hypertension, who were randomized to receive eplerenone (n\u00a0=\u00a016) or amlodipine (n\u00a0=\u00a019) for 1 year, were evaluated. P wave signal\u2010averaged electrocardiography was recorded at baseline and 1 year after entry, and P wave duration (Ad) and P wave dispersion (P\u2010disp) were obtained. Serum levels of intact procollagen type I N\u2010terminal propeptide (PINP) and N\u2010terminal procollagen\u2010III peptide (PIIIP) were also measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in baseline clinical characteristics including Ad, P\u2010disp, and the decrease in blood pressure at 1\u2010year follow\u2010up between the two groups. Ad and P\u2010disp (mean\u00a0\u00b1\u00a0standard deviation) significantly increased in patients on amlodipine after 1 year (140\u00a0\u00b1\u00a021 ms to 139\u00a0\u00b1\u00a019\u00a0ms vs 132\u00a0\u00b1\u00a010 ms to 136\u00a0\u00b1\u00a012\u00a0ms, P\u00a0&lt;\u00a00.01 and 14\u00a0\u00b1\u00a07 ms to 9\u00a0\u00b1\u00a04\u00a0ms vs 12\u00a0\u00b1\u00a05 to 16\u00a0\u00b1\u00a08, P\u00a0&lt;\u00a00.01, respectively). PINP was significantly more decreased in patients with eplerenone than amlodipine (56.6\u00a0\u00b1\u00a030.4 \u03bcg\/mL to 46.6\u00a0\u00b1\u00a019.4 \u03bcg\/mL vs 41.5\u00a0\u00b1\u00a016.2 \u03bcg\/L to 48.7\u00a0\u00b1\u00a021.3 \u03bcg\/L, P\u00a0&lt;\u00a00.01). Percent changes of Ad, P\u2010disp, PINP, and PIIIP were significantly smaller in patients with eplerenone than amlodipine (0.0\u00a0\u00b1\u00a04.7% vs 3.2\u00a0\u00b1\u00a04.4%, P\u00a0&lt;\u00a00.05,\u00a0\u2212\u00a028.6\u00a0\u00b1\u00a031.0% vs 46.3\u00a0\u00b1\u00a073.0%, P\u00a0&lt;\u00a00.01,\u00a0\u2212\u00a05.6\u00a0\u00b1\u00a038.1% vs 22.7\u00a0\u00b1\u00a042.7%, P\u00a0&lt;\u00a00.05, and\u00a0\u2212\u00a09.2\u00a0\u00b1\u00a025.1%\u00a0vs 7.4\u00a0\u00b1\u00a019.0%, P\u00a0&lt;\u00a00.05, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Eplerenone reduced the increase of Ad and P\u2010disp with a decrease of PINP and PIIIP, which might translate into reduction of atrial fibrosis. This study showed that eplerenone may be useful as upstream therapy for AF in patients with hypertension.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13169","type":"journal-article","created":{"date-parts":[[2017,8,28]],"date-time":"2017-08-28T09:52:50Z","timestamp":1503913970000},"page":"1096-1102","source":"Crossref","is-referenced-by-count":8,"title":["Eplerenone might affect atrial fibrosis in patients with hypertension"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-7196","authenticated-orcid":false,"given":"Masato","family":"Kawasaki","sequence":"first","affiliation":[{"name":"Division of Cardiology Osaka General Medical Center  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Cardiology Osaka General Medical Center  Osaka 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