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
Artigo
em Inglês
| 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. .
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Losartan
/
Peptídeo Natriurético Encefálico
/
Bloqueadores do Receptor Tipo 1 de Angiotensina II
/
Antagonistas de Receptores de Angiotensina
/
Insuficiência Cardíaca
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo observacional
/
Estudo prognóstico
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clinics
Assunto da revista:
Medicina
Ano de publicação:
2014
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de São Paulo/BR
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