Russian Heart Failure Journal 2005year Effect of long-term treatment with the ACEI quinapril, the angiotensin II type 1 receptor antagonist valsartan and their combination on parameters of left ventricular remodeling in patients with moderate chronic heart failure
Effect of long-term treatment with the ACEI quinapril, the angiotensin II type 1 receptor antagonist valsartan and their combination on parameters of left ventricular remodeling in patients with moderate chronic heart failure
Skvortsov A.A., Nasonova S.N., Sychev A.V., Baklanova N.A., Mareev V.Yu., Belenkov Yu.N
Urgency. Long-tern increase in the RAAS activity at tissue and organ levels gradually results in death of cardiomyocytes, development of hypertrophy and fibrosis, LV dilatation and changed geometry. In this context, more complete RAAS blockade with combination use of ACEI and ARA seems reasonable to slow down processes of disadaptive LV remodeling. Aim of study: Evaluating the effect of therapy with the ACEI quinapril (Q), the ARA valsartan (V) and the Q+V combination on LV remodeling parameters in patients with moderate CHF. Materials and methods. Eighty patients with II-III NYHA FC CHF were assigned to 3 treatment groups: Q (n=28, 13 mg/day); V (n=26; 121 mg/day) and Q+V (n=26; Q: 12 mg/day; V: 78 mg/day). Follow-up tests included 2D echoCG (LV EDV, LV ESV and LV EF) performed at baseline and after 3 and 6 months of treatment. Results. After 6 months of treatment all groups showed a significant decrease in heart volume parameters. In group V, LV EDV decreased from 295 to 285 ml; in group Q – from 280 to 257 ml, and in group Q+V – from 261 to 224 ml. During contraction, LV ESV decreased from 202 to 181 ml (V); from 193 to 176 ml (Q); and from 192 to 168 ml (Q+V). Absolute increments of LV EF were 4% (р<0.001), 3% (р=0.028) and 4% (р=0.005), respectively. Intergroup differences were not observed. Therefore the combination treatment with the ACEI quinapril and the ARA valsartan enhanced the blockade of LV pathological remodeling but had no significant advantage over monotherapy with quinapril or valsartan in patients with moderate CHF.