Advanced search
Start date
Betweenand
Related content
(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

Full text
Author(s):
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
Affiliation:
[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
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/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 Opportunities: Regular Research Grants