Angiotensin-II Receptor Antagonist Losartan Dose-Dependently Improves the Left Ventricular Remodelling in Patients With Congestive Heart Failure
Journal of Clinical and Basic Cardiology 2002; 5 (1): 83-86
Keywords: Behandlung, kongestive Herzinsuffizienz, Losartan, remodelling, congestive heart failure, Losartan, myocardial remodelling, treatment
This study examined the influence of the AT1-receptor antagonist losartan on myocardial remodelling in patients with congestive heart failure. 240 patients with congestive heart failure functional class 2-4 aged 31-68 years were investigated. The inclusion criteria were left ventricular end-diastolic volume under 160 ml, ejection fraction under 35 %, sinus rhythm and the patient's consent to the study. All patients were randomised into three groups with 80 subjects in each one and all of them received conventional therapy with angiotensin-converting enzyme inhibitor. Placebo was added to conventional therapy in the first group of patients. The second group received losartan 25 mg/d along with conventional therapy. The third group of patients received losartan 50 mg/d. The course of treatment was 48 weeks. Cardiodynamic performances were examined by B-mode and Doppler echocardiography. The analysis of outcomes showed that the decrease of ventricular end-diastolic volume and end-systolic volume, peripheral vessel resistance, Doppler index, myocardial stress index, associated with the increase of cardiac volume and left ventricular ejection fraction was more significant in the third group. Losartan 50 mg/d demonstrated an increased improvement of cardiodynamic status than losartan 25 mg/d and placebo. In conclusion, a dose of 50 mg daily produces a more significant improvement of left ventricular function and myocardial remodelling than 25 mg of losartan.