Document Detail


Effect of the angiotensin receptor blocker Valsartan on coronary microvascular flow reserve in moderately hypertensive patients with stable coronary artery disease.
MedLine Citation:
PMID:  17907015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To noninvasively investigate the effects of the angiotensin receptor blocker (ARB) Valsartan. on myocardial microcirculation in moderately hypertensive patients with stable coronary artery disease (CAD). METHODS AND RESULTS: In this prospective open-label study, patients with mild stable CAD and moderate systolic and/or diastolic hypertension were treated with 160 mg Valsartan daily. Myocardial blood flow was quantified noninvasively using positron emission tomography (PET) with N-13 ammonia at baseline, after one week and after 16 weeks. Mean blood pressure at rest improved significantly from baseline to week 16 (105 +/- 10 vs. 98 +/- 9 mm Hg: p = 0.017, n = 12), but no significant change was observed after one week (103 +/- 11 vs. 100 +/- 11, p = 0.43, n = 13). PET analysis revealed that flow increase during endothelial-dependent, sympathetic stimulation by cold pressor testing (CPT) and in response to pharmacologic vasodilation with adenosine improved from baseline after 1 week (CPT: 1.10 +/- 0.3 vs. 1.37 +/- 0.3; p = 0.017, adenosine: 2.34 +/- 0.52 vs. 2.91 +/- 0.81; p = 0.048) and at week 16 (CPT: 1.15 +/- 0.4 vs 1.39 +/- 0.2; p = 0.10, adenosine: 2.34 +/- 0.52 vs 2.81 +/- 0.91; p = 0.039). CONCLUSIONS: In patients with stable coronary disease, ARB results in improved PET-determined microvascular flow reserve. Improvements in microcirculation preceded the reduction of blood pressure, suggesting direct beneficial effects on microvascular function.
Authors:
Takahiro Higuchi; Claudia Abletshauser; Stephan G Nekolla; Markus Schwaiger; Frank M Bengel
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Microcirculation (New York, N.Y. : 1994)     Volume:  14     ISSN:  1073-9688     ISO Abbreviation:  Microcirculation     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2008-02-15     Completed Date:  2008-05-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9434935     Medline TA:  Microcirculation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  805-12     Citation Subset:  IM    
Affiliation:
Nuklearmedizinische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Antihypertensive Agents / administration & dosage
Coronary Artery Disease / drug therapy,  physiopathology*,  radiography
Female
Fractional Flow Reserve, Myocardial / drug effects*
Humans
Male
Microcirculation / drug effects
Middle Aged
Positron-Emission Tomography
Prospective Studies
Tetrazoles / administration & dosage*
Valine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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