Pulsatile hemodynamic effects of candesartan in patients with chronic heart failure: The CHARM Program
| Autor: | J. Malcolm O. Arnold, Elaine Warner, Mark E. Dunlap, Gordon Marchiori, Shashank Desai, Christopher B. Granger, Gary F. Mitchell, Marc A. Pfeffer, Terrence X. O'Brien |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output Tetrazoles Hemodynamics Blood Pressure Ventricular Function Left Internal medicine medicine Humans Prospective Studies Cardiac Output Systole Antihypertensive Agents Aorta Heart Failure Ejection fraction business.industry Biphenyl Compounds Capillary Resistance Stroke Volume Middle Aged medicine.disease Pulse pressure Candesartan Treatment Outcome Blood pressure Pulsatile Flow Anesthesia Heart failure Chronic Disease Multivariate Analysis Cardiology Benzimidazoles Female Cardiology and Cardiovascular Medicine business Angiotensin II Type 1 Receptor Blockers Compliance Follow-Up Studies medicine.drug |
| Zdroj: | European Journal of Heart Failure. 8:191-197 |
| ISSN: | 1388-9842 |
| Popis: | Background: Abnormal large artery function and increased pulsatile load are exacerbated by excess angiotensin-II acting through the AT1 receptor and contribute to the pathogenesis and progression of chronic heart failure (CHF). Aims: To evaluate effects of the AT1 receptor blocker candesartan (N=30) or placebo (N=34) on pulsatile hemodynamics in participants with CHF in the CHARM program. Methods and results: Noninvasive hemodynamics were assessed following 6 and 14 months of treatment and averaged. Using calibrated tonometry and aortic outflow Doppler, characteristic impedance was calculated as the ratio of the change in carotid pressure and aortic flow in early systole. Total arterial compliance was calculated by the diastolic area method. Brachial blood pressure, cardiac output and peripheral resistance did not differ between groups. Lower central pulse pressure in the candesartan group (57±20 vs. 67±17 mmHg, P=0.043) was accompanied by lower characteristic impedance (200±78 vs. 240±74 dyne s/cm5, P=0.039) and higher total arterial compliance (1.87±0.70 vs. 1.47±0.48 ml/mmHg, P=0.008). Similar favorable differences were seen when analyses were stratified for ejection fraction (≤0.40 vs. >0.40) and baseline angiotensin converting enzyme inhibitor use. Conclusions: Candesartan has a favorable effect on large artery function in patients with chronic heart failure. |
| Databáze: | OpenAIRE |
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