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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

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

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Ochiai, Marcelo E. [1] ; Brancalhao, Euler C. O. [1] ; Puig, Raphael S. N. [1] ; Vieira, Kelly R. N. [1] ; Cardoso, Juliano N. [1] ; de Oliveira-, Jr., Mucio Tavares [1] ; Barretto, Antonio C. P. [1]
Total Authors: 7
[1] Univ Sao Paulo, Heart Inst InCor, Cotoxo Hosp, Sao Paulo - Brazil
Total Affiliations: 1
Document type: Journal article
Source: Clinics; v. 69, n. 5, p. 308-313, 2014.
Web of Science Citations: 1

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. 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/cm(5).m(2), cardiac index 2.8 L/min.m(2), 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. (AU)

FAPESP's process: 06/06463-9 - Angiotensin II receptor type 1 blocker and angiotensin-converting enzyme inhibitor association to severe decompensated heart failure with dobutamine-dependence: effects in hemodynamic, clinical outcomes and mortality
Grantee:Marcelo Eidi Ochiai
Support type: Regular Research Grants