Document Detail


Pharmacotherapy in the treatment of mitral regurgitation: a systematic review.
MedLine Citation:
PMID:  22808826     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Chronic mitral regurgitation (MR) causes volume overload on the left ventricle and, if uncorrected, will over time lead to left ventricular remodeling and heart failure. The benefits of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) in primary MR are not well defined.
METHODS: MEDLINE was searched for studies in which the effects of ACE inhibitors and ARBs on chronic MR had been examined. The inclusion criteria required the patient population to have chronic MR, a normal left ventricular ejection fraction, and to report a quantitative measure of the change in MR severity. Studies in which patients had secondary MR were excluded.
RESULTS: Nineteen studies met the inclusion criteria (13 daily therapy, five single-dose, and one combined study). The pooled mean decrease in regurgitant fraction (RF) was 7.7% [95% CI 4.9, 10.6] and 9.3% [95% CI 3.4, 15.2] for studies in patients with daily therapy and single-dose therapy, respectively. Among studies which reported changes in regurgitant volume (RV), the pooled mean decrease was 7.9 ml [95% CI 1.4, 14.5]. For patients with mitral valve prolapse (MVP), the pooled mean reduction in RF was 8.1% [95% CI 4.3, 11.9] and in rheumatic disease it was 3.4% [95% CI 13.2 - 7.0]. Across the seven studies of daily therapy which reported a change in left ventricular end-diastolic volume index (LVEDVI), the mean decrease was 11.5 ml/m2 [95% CI 2.4, 20.6].
CONCLUSION: ACE inhibitors and ARBs each reduced the RF, RV, and left ventricular size by a modest degree in chronic primary MR.
Authors:
Craig E Strauss; Sue Duval; Dan Pastorius; Kevin M Harris
Related Documents :
234546 - Left and right ventricular volumes in a-v block, and their changes induced by the infus...
8160286 - The influence of pulmonary insufficiency on ventricular function following total correc...
17171886 - Influence of acute preoperative hemodilution on right ventricular function.
1253196 - The accuracy of caridac function indices derived from ultrasonic time-position scans.
9424076 - Myocardial damage does not occur in untreated hyperthyroidism unless associated with co...
3873186 - Biventricular function after myocardial revascularization in humans: deterioration and ...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  21     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  275-85     Citation Subset:  IM    
Affiliation:
Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, MN 55407, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Anaesthetic management of patients with Xeroderma pigmentosum. A series of three cases.
Next Document:  Strength comparison of mitral annuloplasty ring and suturing combinations: an in-vitro study.