Addition of Angiotensin II Receptor Blockade to Maximal Angiotensin-Converting Enzyme Inhibition Improves Exercise Capacity in Patients With Severe Congestive Heart Failure
| Autor: | S. Thomas, T H Le Jemtel, R Patel, G. Hamroff, Guillaume Jondeau, M.-T. Olivari, Donna M. Mancini, I. Blaufarb, Stuart D. Katz, Rachel Bijou |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Angiotensin receptor Angiotensin-Converting Enzyme Inhibitors Losartan Angiotensin Receptor Antagonists Double-Blind Method Physiology (medical) Internal medicine Humans Medicine Exercise Aged Heart Failure Angiotensin II receptor type 1 biology business.industry Captopril Angiotensin-converting enzyme Middle Aged medicine.disease Angiotensin II Endocrinology Heart failure biology.protein Cardiology Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Circulation. 99:990-992 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.99.8.990 |
| Popis: | Background —Incomplete suppression of the renin-angiotensin system during long-term ACE inhibition may contribute to symptomatic deterioration in patients with severe congestive heart failure (CHF). Combined angiotensin II type I (AT 1 ) receptor blockade and ACE inhibition more completely suppresses the activated renin-angiotensin system than either intervention alone in sodium-depleted normal individuals. Whether AT 1 receptor blockade with losartan improves exercise capacity in patients with severe CHF already treated with ACE inhibitors is unknown. Methods and Results —Thirty-three patients with severe CHF despite treatment with maximally recommended or tolerated doses of ACE inhibitors were randomized 1:1 to receive 50 mg/d losartan or placebo for 6 months in addition to standard therapy in a multicenter, double-blind trial. Peak aerobic capacity (V̇ o 2 ) during symptom-limited treadmill exercise and NYHA functional class were determined at baseline and after 3 and 6 months of double-blind therapy. Peak V̇ o 2 at baseline and after 3 and 6 months were 13.5±0.6, 15.1±1.0, and 15.7±1.1 mL · kg −1 · min −1 , respectively, in patients receiving losartan and 14.1±0.6, 14.3±0.9, and 13.6±1.1 mL · kg −1 · min −1 , respectively, in patients receiving placebo ( P Conclusions —Losartan enhances peak exercise capacity and alleviates symptoms in patients with CHF who are severely symptomatic despite treatment with maximally recommended or tolerated doses of ACE inhibitors. |
| Databáze: | OpenAIRE |
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