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Article: Aldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failure

TitleAldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failure
Authors
Issue Date2007
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jac
Citation
Journal Of The American College Of Cardiology, 2007, v. 50 n. 7, p. 591-596 How to Cite?
AbstractObjectives: The objective of this study was to determine if adding spironolactone to an angiotensin II receptor blocker improves left ventricular (LV) function, mass, and volumes in chronic heart failure. Background: Add-on spironolactone therapy substantially improves clinical outcomes among patients with severe heart failure (HF) on standard therapy. However, the value of combining spironolactone with an angiotensin II receptor blocker on LV reverse remodeling in mild-to-moderate systolic HF is unclear. Methods: Fifty-one systolic HF patients with left ventricular ejection fraction (LVEF) <40% were randomly assigned to receive 1-year treatment of candesartan and spironolactone (combination group) or candesartan and placebo (control group). Reverse remodeling was assessed by serial cardiac magnetic resonance imaging and echocardiographic tissue Doppler imaging (TDI). Results: There were significant improvements in LVEF (35 ± 3% vs. 26 ± 2%, p < 0.01) and reduction of LV end-diastolic volume index (121 ± 16 ml/m 2 vs. 155 ± 14 ml/m 2, p = 0.001), end-systolic volume index (88 ± 17 ml/m 2 vs. 120 ± 15 ml/m 2, p < 0.0005), and LV mass index (81 ± 6 g/m 2 vs. 93 ± 6 g/m 2, p = 0.002) in the combination group at 1 year. In addition, there was significant increase in peak basal systolic velocity and strain by TDI, decrease in index of filling pressure, and increase in cyclic variation integrated backscatter. In the control group, there were no significant changes in all these parameters after 1 year. Conclusions: The addition of spironolactone to candesartan has significant beneficial effects on LV reverse remodeling in patients with mild-to-moderate chronic systolic HF. © 2007 American College of Cardiology Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/163093
ISSN
2023 Impact Factor: 21.7
2023 SCImago Journal Rankings: 8.762
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, AKYen_HK
dc.contributor.authorSanderson, JEen_HK
dc.contributor.authorWang, Ten_HK
dc.contributor.authorLam, Wen_HK
dc.contributor.authorYip, Gen_HK
dc.contributor.authorWang, Men_HK
dc.contributor.authorLam, YYen_HK
dc.contributor.authorZhang, Yen_HK
dc.contributor.authorYeung, Len_HK
dc.contributor.authorWu, EBen_HK
dc.contributor.authorChan, WWMen_HK
dc.contributor.authorWong, JTHen_HK
dc.contributor.authorSo, Nen_HK
dc.contributor.authorYu, CMen_HK
dc.date.accessioned2012-09-05T05:27:29Z-
dc.date.available2012-09-05T05:27:29Z-
dc.date.issued2007en_HK
dc.identifier.citationJournal Of The American College Of Cardiology, 2007, v. 50 n. 7, p. 591-596en_HK
dc.identifier.issn0735-1097en_HK
dc.identifier.urihttp://hdl.handle.net/10722/163093-
dc.description.abstractObjectives: The objective of this study was to determine if adding spironolactone to an angiotensin II receptor blocker improves left ventricular (LV) function, mass, and volumes in chronic heart failure. Background: Add-on spironolactone therapy substantially improves clinical outcomes among patients with severe heart failure (HF) on standard therapy. However, the value of combining spironolactone with an angiotensin II receptor blocker on LV reverse remodeling in mild-to-moderate systolic HF is unclear. Methods: Fifty-one systolic HF patients with left ventricular ejection fraction (LVEF) <40% were randomly assigned to receive 1-year treatment of candesartan and spironolactone (combination group) or candesartan and placebo (control group). Reverse remodeling was assessed by serial cardiac magnetic resonance imaging and echocardiographic tissue Doppler imaging (TDI). Results: There were significant improvements in LVEF (35 ± 3% vs. 26 ± 2%, p < 0.01) and reduction of LV end-diastolic volume index (121 ± 16 ml/m 2 vs. 155 ± 14 ml/m 2, p = 0.001), end-systolic volume index (88 ± 17 ml/m 2 vs. 120 ± 15 ml/m 2, p < 0.0005), and LV mass index (81 ± 6 g/m 2 vs. 93 ± 6 g/m 2, p = 0.002) in the combination group at 1 year. In addition, there was significant increase in peak basal systolic velocity and strain by TDI, decrease in index of filling pressure, and increase in cyclic variation integrated backscatter. In the control group, there were no significant changes in all these parameters after 1 year. Conclusions: The addition of spironolactone to candesartan has significant beneficial effects on LV reverse remodeling in patients with mild-to-moderate chronic systolic HF. © 2007 American College of Cardiology Foundation.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_HK
dc.relation.ispartofJournal of the American College of Cardiologyen_HK
dc.subject.meshAgeden_US
dc.subject.meshAldosterone Antagonists - Administration & Dosageen_US
dc.subject.meshAngiotensin Ii Type 1 Receptor Blockers - Administration & Dosageen_US
dc.subject.meshBenzimidazoles - Administration & Dosageen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Failure - Drug Therapy - Pathology - Ultrasonographyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSpironolactone - Administration & Dosageen_US
dc.subject.meshTetrazoles - Administration & Dosageen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVentricular Remodeling - Drug Effectsen_US
dc.titleAldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failureen_HK
dc.typeArticleen_HK
dc.identifier.emailWang, M: meiwang@hkucc.hku.hken_HK
dc.identifier.emailWong, JTH: jwong@hkucc.hku.hken_HK
dc.identifier.authorityWang, M=rp00281en_HK
dc.identifier.authorityWong, JTH=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.jacc.2007.03.062en_HK
dc.identifier.pmid17692742-
dc.identifier.scopuseid_2-s2.0-34547555364en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34547555364&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume50en_HK
dc.identifier.issue7en_HK
dc.identifier.spage591en_HK
dc.identifier.epage596en_HK
dc.identifier.isiWOS:000249049300004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, AKY=7403168116en_HK
dc.identifier.scopusauthoridSanderson, JE=7202371250en_HK
dc.identifier.scopusauthoridWang, T=7405562167en_HK
dc.identifier.scopusauthoridLam, W=13410486800en_HK
dc.identifier.scopusauthoridYip, G=7006525328en_HK
dc.identifier.scopusauthoridWang, M=7406690398en_HK
dc.identifier.scopusauthoridLam, YY=13003018600en_HK
dc.identifier.scopusauthoridZhang, Y=7601312580en_HK
dc.identifier.scopusauthoridYeung, L=7004462802en_HK
dc.identifier.scopusauthoridWu, EB=9234022900en_HK
dc.identifier.scopusauthoridChan, WWM=25947299100en_HK
dc.identifier.scopusauthoridWong, JTH=8049324500en_HK
dc.identifier.scopusauthoridSo, N=7003780596en_HK
dc.identifier.scopusauthoridYu, CM=7404976646en_HK
dc.identifier.issnl0735-1097-

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