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Title: 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
Authors: OCHIAI, Marcelo E.BRANCALHAO, Euler O.PUIG, Raphael S.VIERA, Kelly N.LIMA, Marcelo V.CARDOSO, Juliano N.BARRETTO, Antonio P.
Citation: JOURNAL OF CARDIAC FAILURE, v.18, n.8, suppl.1, p.S61-S61, 2012
Abstract: Objectives: 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.
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Comunicações em Eventos - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Comunicações em Eventos - HC/HA
Hospitais Auxiliares - HC/HA

Comunicações em Eventos - HC/InCor
Instituto do Coração - HC/InCor

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