Short-term add-on therapy with angiotensin receptor blocker for end-stage inotrope-dependent heart failure patients: B-type natriuretic peptide reduction in a randomized clinical trial
Clinics
;
69(5): 308-313, 2014. tab, graf
Article
in English
| LILACS
| ID: lil-709611
ABSTRACT
OBJECTIVE:
We aimed to evaluate angiotensin receptor blocker add-on therapy in patients with low cardiac output during decompensated heart failure.METHODS:
We selected patients with decompensated heart failure, low cardiac output, dobutamine dependence, and an ejection fraction <0.45 who were receiving an angiotensin-converting enzyme inhibitor. The patients were randomized to losartan or placebo and underwent invasive hemodynamic and B-type natriuretic peptide measurements at baseline and on the seventh day after intervention. ClinicalTrials.gov NCT01857999.RESULTS:
We studied 10 patients in the losartan group and 11 patients in the placebo group. The patient characteristics were as follows age 52.7 years, ejection fraction 21.3%, dobutamine infusion 8.5 mcg/kg.min, indexed systemic vascular resistance 1918.0 dynes.sec/cm5.m2, cardiac index 2.8 L/min.m2, and B-type natriuretic peptide 1,403 pg/mL. After 7 days of intervention, there was a 37.4% reduction in the B-type natriuretic peptide levels in the losartan group compared with an 11.9% increase in the placebo group (mean difference, -49.1%; 95% confidence interval -88.1 to -9.8%, p = 0.018). No significant difference was observed in the hemodynamic measurements.CONCLUSION:
Short-term add-on therapy with losartan reduced B-type natriuretic peptide levels in patients hospitalized for decompensated severe heart failure and low cardiac output with inotrope dependence. .
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Losartan
/
Natriuretic Peptide, Brain
/
Angiotensin II Type 1 Receptor Blockers
/
Angiotensin Receptor Antagonists
/
Heart Failure
Type of study:
Controlled clinical trial
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2014
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR
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