Document Detail


Haemodynamic and endocrine effects of type 1 angiotensin II receptor blockade in patients with hypoxaemic cor pulmonale.
MedLine Citation:
PMID:  9059545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Angiotensin II (ANG II) is known to be a potent vasoconstrictor agent in the pulmonary circulation. Furthermore, type 1 ANG II receptor blockade with losartan attenuates acute hypoxic pulmonary vasoconstriction in normal subjects. The aim of this study was therefore to evaluate the haemodynamic and endocrine sequelae of type 1 ANG II receptor blockade in patients with hypoxaemic cor pulmonale. METHODS: Nine patients with chronic obstructive pulmonary disease (COPD) age 67 +/- 3 years with pulmonary hypertension and normal left ventricular systolic function were studied on two separate occasions in a double-blind, placebo-controlled, crossover study. They were randomised to receive either 50 mg of oral losartan or matched placebo. Pulsed wave Doppler echocardiography was used to measure cardiac output (CO), mean pulmonary artery pressure (MPAP) and hence systemic vascular resistance (SVR) and total pulmonary vascular resistance (TPR). Haemodynamic measurements and venous blood samples were taken at baseline and after 2 and 4 h. RESULTS: Maximal effects were observed at 4 h where losartan compared to placebo resulted in a significant reduction in both MPAP (28.6 +/- 2.0 vs 32.4 +/- 1.5 mmHg) and TPR (428 +/- 40 vs 510 +/- dyn.s.cm-5), respectively. Similarly losartan compared to placebo resulted in a significant reduction in MAP (87 +/- 4.5 vs 93 +/- 3.2 mmHg) and SVR (1293 +/- 94 vs 1462 +/- 112 dyn.s.cm-5), and significantly increased CO (5.58 +/- 0.43 vs 5.31 +/- 0.42 l/min). In addition, plasma aldosterone was significantly lower after treatment with losartan compared to placebo: 76 +/- 23 vs 164 +/- 43 pg/ml respectively. CONCLUSIONS: Thus, selective type 1 ANG II receptor blockade appears to have beneficial pulmonary and endocrine effects, suggesting a possible therapeutic role in the management of hypoxaemic cor pulmonale.
Authors:
D G Kiely; R I Cargill; N M Wheeldon; W J Coutie; B J Lipworth
Related Documents :
393505 - Effects of an angiotensin ii antagonist; [sarcosine 1, isoleucine 8] angiotensin ii, on...
2839205 - Potent depressor action of leumorphin, a kappa-opioid agonist, in conscious rats.
1395115 - Remodelling of the vascular system in response to hypertension and drug therapy.
16810285 - Ace and ace2: their role to balance the expression of angiotensin ii and angiotensin-(1...
2297955 - The slope of the end-systolic pressure-volume relationship compared with the global end...
21862455 - Elevated n-terminal pro-brain natriuretic peptide levels predict an enhanced anti-hyper...
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular research     Volume:  33     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-03-28     Completed Date:  1997-03-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  201-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacology, Ninewells Hospital and Medical School, University of Dundee, Scotland, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Angiotensin II / antagonists & inhibitors*
Antihypertensive Agents / therapeutic use*
Biphenyl Compounds / therapeutic use*
Cross-Over Studies
Double-Blind Method
Echocardiography, Doppler, Pulsed
Female
Humans
Hypertension, Pulmonary / blood,  drug therapy,  ultrasonography
Imidazoles / therapeutic use*
Losartan
Lung Diseases, Obstructive / blood,  drug therapy,  ultrasonography
Male
Pulmonary Heart Disease / blood,  drug therapy*,  ultrasonography
Receptors, Angiotensin / antagonists & inhibitors*
Tetrazoles / therapeutic use*
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Imidazoles; 0/Receptors, Angiotensin; 0/Tetrazoles; 11128-99-7/Angiotensin II; 114798-26-4/Losartan; 52-39-1/Aldosterone

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


Previous Document:  Endothelin-1 in the lungs of patients with pulmonary hypertension.
Next Document:  Cardiopulmonary bypass tubes and prime solutions stimulate neutrophil adhesion molecules.