Document Detail

Beneficial effect of replacing of angiotensin-converting enzyme inhibitor with angiotensin II antagonist for heart failure patients.
MedLine Citation:
PMID:  12174028     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Angiotensin-converting enzyme (ACE) inhibitors and beta-blockers improve prognosis inpatients with chronic heart failure. Some patients, however, show little response to combined treatment with an ACE inhibitor and a beta-blocker. In addition, the ACE inhibitor cannot completely suppress angiotensin II production. Our objective was to examine whether replacing the ACE inhibitor with an angiotensin II antagonist can improve the condition of patients with chronic heart failure. METHODS: In 11 patients with chronic heart failure treated with an ACE inhibitor and a beta-blocker, who have had severe left ventricular dysfunction or high plasma level of natriuretic peptides, left ventricular dimension, and fractional shortening, plasma atrial and brain natriuretic peptide (ANP and BNP) levels were determined before and 3 months after the change of treatment. RESULTS: After substituting the ACE inhibitor with an angiotensin II antagonist, patients showed New York Heart Association functional class improvement, and significant decrease in left ventricular dimension and BNP. CONCLUSION: In patients with severe chronic heart failure treated with an ACE inhibitor and a beta-blocker, replacing the ACE inhibitor with an angiotensin II antagonist may be effective. However, this has to be confirmed by an adequately powered randomized controlled study.
Y Hara; M Hamada; Y Shigematsu; T Ohtsuka; K Hiwada
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  27     ISSN:  0269-4727     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-13     Completed Date:  2003-01-29     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  267-71     Citation Subset:  IM    
The Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime, Japan.
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MeSH Terms
Angiotensin II / antagonists & inhibitors*
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use*
Atrial Natriuretic Factor / analysis
Drug Therapy, Combination
Heart Failure / etiology*,  pathology
Middle Aged
Natriuretic Peptide, Brain / analysis
Treatment Outcome
Ventricular Dysfunction, Left
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 11128-99-7/Angiotensin II; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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