Forschungsdatenbank PMU-SQQUID

PMU-Autor/inn/en

Abstract

A total of 172 patients with cardiac failure (CF) of functional class II-IV aged 46-62 years were studied. Clinical condition of the patients was stabilized by the conventional therapy including ACE inhibitor--enalapril in a dose 10-20 mg/day. In 3 weeks this therapy was combined with losartan in a dose 25-50 mg/day. The course of treatment was 48 weeks. Cardiodynamics was assessed by duplex echocardiography and dopplerography. Plasmic concentrations of atrial sodiumuretic peptide (ASUP), renin, angiotensin-II, aldosteron, norepinephrine, epinephrine, serotonin, hydrocortisone, endothelin-1 were measured with radioimmunoassay. In the study group there were 31 deaths for 48 weeks. ASUP concentration in the deceased was significantly higher than in the survivors (n = 141). The stepwise regression analysis discovered correlation between plasmic ASUP and end-diastolic volume of the left ventricle (r = 0.62; p = 0.01), dopplerographic index (r = 0.52; p = 0.001), left ventricular ejection fraction (r = -0.66; p = 0.002), velocity of early diastolic filling (r = -0.84; p = 0.001), plasmic pool of norepinephrine (r = 0.66; p = 0.001), endotheline-1 (r = 0.70; p = 0.03) and angiotensin-II (r = 0.55; p = 0.02), daily dose of furosemide (r = 0.80; p = 0.001), heart rate (r = 0.64; p = 0.02). The strongest negative effect on CF patients survival was linked with plasmic content of ASUP (relative risk = 4.55), angiotensin-II (RR = 3.2), ejection fraction < 25% (RR = 3.02). Thus, elevation of ASUP in blood plasm can be regarded a marker of a high cardiovascular risk of CF patients treated with AT-antagonist.

Useful keywords (using NLM MeSH Indexing)

Adult

Angiotensin-Converting Enzyme Inhibitors/administration*

dosage

Angiotensin-Converting Enzyme Inhibitors/therapeutic use

Anti-Arrhythmia Agents/administration*

dosage

Anti-Arrhythmia Agents/therapeutic use

Antihypertensive Agents/administration*

dosage

Antihypertensive Agents/therapeutic use

Atrial Natriuretic Factor/blood*

Drug Therapy, Combination

Echocardiography, Doppler

Enalapril/administration*

dosage

Enalapril/therapeutic use

Female

Heart Failure/blood

Heart Failure/diagnosis*

Heart Failure/diagnostic imaging

Heart Failure/drug therapy

Heart Failure/mortality

Heart Failure/physiopathology

Humans

Losartan/administration*

dosage

Losartan/therapeutic use

Male

Middle Aged

Prognosis

Radioimmunoassay

Regression Analysis

Risk

Time Factors