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Titolo:
Early neurohormonal effects of trandolapril in patients with left ventricular dysfunction and a recent acute myocardial infarction: a double-blind, randomized, placebo-controlled multicentre study
Autore:
Sigurdsson, A; Eriksson, SV; Hall, C; Kahan, T; Swedberg, K;
Indirizzi:
Landspitalinn V Hringbraut, Dept Med, Div Cardiol, IS-101 Reykjavik, Iceland Landspitalinn V Hringbraut Reykjavik Iceland IS-101 1 Reykjavik, Iceland Karolinska Inst, Danderyd Hosp, Div Internal Med, S-18288 Danderyd, SwedenKarolinska Inst Danderyd Sweden S-18288 al Med, S-18288 Danderyd, Sweden Univ Oslo, Rikshosp, Inst Surg Res, N-0027 Oslo, Norway Univ Oslo Oslo Norway N-0027 ikshosp, Inst Surg Res, N-0027 Oslo, Norway Sahlgrens Univ Hosp, Dept Med, S-41345 Gothenburg, Sweden Sahlgrens Univ Hosp Gothenburg Sweden S-41345 S-41345 Gothenburg, Sweden
Titolo Testata:
EUROPEAN JOURNAL OF HEART FAILURE
fascicolo: 1, volume: 3, anno: 2001,
pagine: 69 - 78
SICI:
1388-9842(200101)3:1<69:ENEOTI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANGIOTENSIN-CONVERTING-ENZYME; PROATRIAL NATRIURETIC FACTOR; CONGESTIVE-HEART-FAILURE; LONG-TERM PROGNOSIS; NEUROPEPTIDE-Y; PLASMA; MORTALITY; RADIOIMMUNOASSAY; PERFORMANCE; INHIBITION;
Keywords:
neurohormonal activation; acute myocardial infarction; left ventricular dysfunction; angiotensin converting enzyme inhibitors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Sigurdsson, A Landspitalinn V Hringbraut, Dept Med, Div Cardiol, IS-101 Reykjavik, Iceland Landspitalinn V Hringbraut Reykjavik Iceland IS-101 celand
Citazione:
A. Sigurdsson et al., "Early neurohormonal effects of trandolapril in patients with left ventricular dysfunction and a recent acute myocardial infarction: a double-blind, randomized, placebo-controlled multicentre study", EUR J HE FA, 3(1), 2001, pp. 69-78

Abstract

Angiotensin-converting enzyme inhibitors improve long-term survival in patients with left ventricular dysfunction after a myocardial infarction, but their mechanism of action is not entirely clear. The neurohormonal effects may be important in this respect, as well as an early hemodynamic unloadinginduced by these drugs. The primary objective was to assess the effect of trandolapril on plasma levels of atrial natriuretic peptide. A secondary objective was to assess the effects of trandolapril on selected neurohormones, vasoactive peptides and enzymes, which may be important in the development of left ventricular remodeling and heart failure following an acute myocardial infarction. A total of 119 patients with an acute myocardial infarction and a wall motion index less than or equal to1.2 (16-segment echocardiographic model) were randomized to double blind treatment with trandolapril or placebo within 3-7 days after the onset of infarction. Blind treatment was discontinued 21 days after the index infarction. Venous blood samples were collected at rest, before randomization and on the day after treatment was discontinued. At the end of the study, there were no differences in plasma levels of atrial natriuretic peptide between the two treatment groups. Angiotensin-converting enzyme activity was suppressed and plasma renin activity was higher in the trandolapril group. No differences in plasma levels ofN-terminal pro-atrial natriuretic peptide, brain natriuretic peptide, aldosterone, noradrenaline, adrenaline, vasopressin, big endothelin-l and neuropeptide Y were found between the two treatment groups. There were positive correlations between several markers of neurohormonal activation at baseline and variables expressing left ventricular dysfunction and clinical heart failure. Neurohormonal activation is related to left ventricular dysfunction. The effects of 2-3 weeks of angiotensin-converting enzyme inhibition on neurohormonal activation does not predict the already established beneficial long-term effects after myocardial infarction. Thus, early modulation of circulatory neurohormone levels may not be a major mechanism for the efficacy of angiotensin-converting enzyme inhibitors in these patients. Selected plasma hormone markers may still be used to identify patients who might getthe greatest benefit from treatment. (C) 2001 European Society of Cardiology. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 13:08:29