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Titolo:
Effects of losartan and captopril on left ventricular volumes in elderly patients with heart failure: Results of the ELITE ventricular function substudy
Autore:
Konstam, MA; Patten, RD; Thomas, I; Ramahi, T; La Bresh, K; Goldman, S; Lewis, W; Gradman, A; Self, KS; Bittner, V; Rand, W; Kinan, D; Smith, RJ; Ford, T; Segal, R; Udelson, JE;
Indirizzi:
Tufts Univ, New England Med Ctr, Dept Med, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111 nd Med Ctr, Dept Med, Boston, MA 02111 USA Inst Med Res, Sidell, LA USA Inst Med Res Sidell LA USAInst Med Res, Sidell, LA USA Brown Univ, Pawtucket, RI USA Brown Univ Pawtucket RI USABrown Univ, Pawtucket, RI USA Vet Adm Hosp, Tucson, AZ USA Vet Adm Hosp Tucson AZ USAVet Adm Hosp, Tucson, AZ USA Univ Calif Davis, Med Ctr, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 ed Ctr, Sacramento, CA 95817 USA Western Penn Hosp, Pittsburgh, PA 15224 USA Western Penn Hosp Pittsburgh PA USA 15224 Hosp, Pittsburgh, PA 15224 USA Self Ctr PC, Fairhope, AL USA Self Ctr PC Fairhope AL USASelf Ctr PC, Fairhope, AL USA Univ Alabama, Birmingham, AL USA Univ Alabama Birmingham AL USAUniv Alabama, Birmingham, AL USA Merck & Co Inc, W Point, PA USA Merck & Co Inc W Point PA USAMerck & Co Inc, W Point, PA USA
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 6, volume: 139, anno: 2000,
pagine: 1081 - 1087
SICI:
0002-8703(200006)139:6<1081:EOLACO>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; 2-DIMENSIONAL ECHOCARDIOGRAPHIC MEASUREMENTS; ENZYME-INHIBITOR ENALAPRIL; LONG-TERM PROGRESSION; END-SYSTOLIC VOLUME; ANGIOTENSIN-II; CARDIAC FIBROBLASTS; RECEPTOR BLOCKADE; CLINICAL STATUS; DYSFUNCTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Konstam, MA Tufts Univ, New England Med Ctr, Dept Med, Box 108,750 Washington St, Boston, MA 02111 USA Tufts Univ Box 108,750 Washington St Boston MAUSA 02111 1 USA
Citazione:
M.A. Konstam et al., "Effects of losartan and captopril on left ventricular volumes in elderly patients with heart failure: Results of the ELITE ventricular function substudy", AM HEART J, 139(6), 2000, pp. 1081-1087

Abstract

Background The mechanism by which angiotensin-converting enzyme inhibitorsreduce mortality rater and disease progression in patients with heart failure is likely mediated in part through prevention of adverse ventricular remodeling. This study examined the effects of the angiotensin-converting enzyme inhibitor captopril and the angiotensin II type 1 receptor antagonist losartan on ventricular volumes and function in elderly patients with heart failure and reduced left ventricular ejection fraction (less than or equal to 40%). Methods Patients underwent radionuclide ventriculograms (RVG) at baseline and were randomized to either captopril (n = 16) or losartan (n = 13). After 48 weeks, another RVG was obtained. Therapy was then withdrawn for at least 5 days, and the RVG was repeated while the patient was not receiving thedrug. Results At 48 weeks both captopril and losartan significantly reduced leftventricular (LV) end-diastolic volume index (135 +/- 26 to 128 +/- 23 mL/m(2) for losartan, P < .05 vs baseline; 142 +/- 25 to 131 +/- 20 ml/m(2) forcaptopril, P < .01; mean (SD). Captopril also reduced LV end-systolic volume index (98 +/- 24 to 89 +/- 21 mL/m(2), P < .01 vs, baseline), whereas a nonsignificant trend was observed for the losartan group (97 +/- 23 to 90 +/- 16 mL/m(2), P = not significant). The betweengroup differences in the changes in LV volumes were not statistically significant. After drug withdrawal, LV end-diastolic volume index remained significantly lower than baseline in the captopril group (P < .01). Conclusions Both captopril and losartan prevent LV dilation, representing adverse ventricular remodeling, previously seen with placebo treatment. Reverse remodeling was observed in the captopril group. On the basis of these results, the relative effects on IV remodeling do not provide a rationale for a survival benefit of losartan over captopril.

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Documento generato il 05/12/20 alle ore 07:52:29