Long-Term Combined Therapy with an Angiotensin Type I Receptor Blocker and an Angiotensin Converting Enzyme Inhibitor Prolongs Survival in Dilated Cardiomyopathy
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概要
- 論文の詳細を見る
The efficacy of ACE inhibitors (ACEIs) in the treatment of chronic heart failures is well documented. However, ACEIs may provide incomplete blockade of the renin-angiotensin system (RAS) because of the alternative pathways for angiotensin II (AII) production. We hypothesized that more complete blockade of RAS by adding an AT1 receptor blocker (ARB) may have greater potential to decrease mortality associated with heart failure and improve cardiac function than monotherapy with ACEIs. The objective of this study was to evaluate the effect of combined therapy on cardiac functions and survival in cardiomyopathic hamsters. Male cardiomyopathic hamsters (BIO TO2) were administered either placebo (group C), enalapril (30 mg/kg/day) (group E), or enalapril (30 mg/kg/day) + valsartan (500 mg/kg/day) (groupEV), starting at the age of 6 weeks. Kaplan-Meier analysis was performed to assess the differences in survival. Cardiac functions were evaluated by echocardiogram and cardiac catheterization. Group EV showed significant increases in fractional shortening, LV dP / dTmax, and deceleration time, and showed significant decreases in left ventricular diastolic dimension, LV dP / dTmin, and early diastolic mitral velocity / atrial systolic velocity. Treatment with enalapril resulted in longer survival compared with placebo. Moreover, life expectancy (median probability of survival: 433 days) increased significantly in group EV compared with group E (P<0.05) as well as group C (P<0.001). It is concluded that combined therapy improved cardiac function and survival compared to placebo or enalapril monotherapy.
- Japanese Heart Journal Associationの論文
著者
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Matsui Yutaka
大阪大学 薬学研究科臨床薬効解析学
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Shimizu Toshihiro
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Okamoto Hiroshi
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Chiba Satoru
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Matsui Yutaka
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Sugawara Takeshi
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Onozuka Hisao
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Mikami Taisei
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Kumamoto Hideki
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Kitabatake Akira
the Department of Cardiovascular Medicine, Graduate School of Medicine
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Kitabatake Akira
The Department Of Cardiovascular Medicine Hokkaido University
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Mikami Taisei
The Department Of Cardiovascular Medicine Hokkaido University School Of Medicine
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