Short-Term Add-On Therapy With Angiotensin Receptor Blocker for End-Stage Inotrope-Dependent Heart Failure Patients: B-Type Natriuretic Peptide Reduction in a Randomized Clinical Trial

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorOCHIAI, Marcelo E.
dc.contributor.authorBRANCALHAO, Euler O.
dc.contributor.authorPUIG, Raphael S.
dc.contributor.authorVIERA, Kelly N.
dc.contributor.authorLIMA, Marcelo V.
dc.contributor.authorCARDOSO, Juliano N.
dc.contributor.authorBARRETTO, Antonio P.
dc.date.accessioned2013-10-11T21:17:42Z
dc.date.available2013-10-11T21:17:42Z
dc.date.issued2012
dc.description.abstractObjectives: The dual blockage of renin-angiotensin-aldosterone system could be useful for end-stage inotrope-dependent patients. The objective of this study was to evaluate the effects of angiotensin receptor blocker add-on therapy in low cardiac output in decompensated heart failure. Methods: We selected patients hospitalized for decompensated heart failure with low cardiac output and dobutamine dependence, ejection fraction < 0.45, spontaneous breathing and receiving angiotensin-converting enzyme (ACE) inhibitor. They were randomized to losartan or placebo and underwent invasive hemodynamic and B-type natriuretic peptide (BNP) measurements at baseline and on the seventh day of intervention. Results: We studied 10 patients in losartan group and 11 patients in placebo group, the main characteristics were 52.7 years old, ejection fraction of 21.3%, dobutamine infusion of 8.5mcg/kg.min, indexed systemic vascular resistance of 1918.0 dynes.sec/cm5.m2, cardiac index of 2.8 L/min.m2, and BNP of 1,403 pg/mL. After 7 days of intervention, there was a reduction of 37.4% in BNP levels in the losartan group, compared with an increase of 11.9% in the placebo group (mean difference, -49.1%; 95% CI: -88.1 to -9.8%, P = 0.018). No significant difference was found in hemodynamic measurements. Conclusions: Short-term add-on therapy with losartan reduced BNP levels in patients hospitalized for decompensated severe heart failure and low cardiac output with inotrope dependence.
dc.description.conferencedateSEP 09-12, 2012
dc.description.conferencelocalSeattle - WA, EUA
dc.description.conferencename16th Annual Scientific Meeting of the Heart-Failure-Society-of-America
dc.description.indexMEDLINE
dc.identifier.citationJOURNAL OF CARDIAC FAILURE, v.18, n.8, suppl.1, p.S61-S61, 2012
dc.identifier.issn1071-9164
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/2785
dc.language.isoeng
dc.publisherCHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
dc.relation.ispartofJournal of Cardiac Failure
dc.rightsrestrictedAccess
dc.rights.holderCopyright CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
dc.subject.wosCardiac & Cardiovascular Systems
dc.titleShort-Term Add-On Therapy With Angiotensin Receptor Blocker for End-Stage Inotrope-Dependent Heart Failure Patients: B-Type Natriuretic Peptide Reduction in a Randomized Clinical Trial
dc.typeconferenceObject
dc.type.categorymeeting abstract
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalBRANCALHAO, Euler O.:Univ Sao Paulo, Cotoxo Hosp, Heart Inst INCOR, BR-05508 Sao Paulo, Brazil
hcfmusp.author.externalVIERA, Kelly N.:Univ Sao Paulo, Cotoxo Hosp, Heart Inst INCOR, BR-05508 Sao Paulo, Brazil
hcfmusp.contributor.author-fmusphcMARCELO EIDI OCHIAI
hcfmusp.contributor.author-fmusphcRAPHAEL STORTI NETTO PUIG
hcfmusp.contributor.author-fmusphcMARCELO VILLACA LIMA
hcfmusp.contributor.author-fmusphcJULIANO NOVAES CARDOSO
hcfmusp.contributor.author-fmusphcANTONIO CARLOS PEREIRA BARRETTO
hcfmusp.description.beginpageS61
hcfmusp.description.endpageS61
hcfmusp.description.issue8
hcfmusp.description.issuesuppl 1
hcfmusp.description.volume18
hcfmusp.origemWOS
hcfmusp.origem.wosWOS:000307679700198
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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relation.isAuthorOfPublication8f825c89-f388-4e66-b0d0-27f7025d408c
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relation.isAuthorOfPublication.latestForDiscovery3c9524ea-aced-46c9-bead-67c58c85dd00
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