A randomised, controlled, double-blind, cross-over pilot study assessing the effects of spironolactone, losartan and their combination on heart rate variability and QT dispersion in patients with chronic heart failure

Cardiovascular Journal of Africa

Volumn 19, Issue 6, 2008, Pages 292-296

  Shehab, A ^a,b   Elnour, A A ^a,b   Struthers, A D ^c  

^a UNITED ARAB EMIRATES UNIVERSITY   (United Arab Emirates)

^b MEDICAL UNIVERSITY OF VIENNA   (Austria)

^c UNIVERSITY OF DUNDEE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ALDOSTERONE; ANGIOTENSIN RECEPTOR; DIGOXIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; FUROSEMIDE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOSARTAN; NITRATE; SPIRONOLACTONE;

ADULT; AGED; ARTICLE; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROSSOVER PROCEDURE; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; ELECTROCARDIOGRAM; FEMALE; HEART EJECTION FRACTION; HEART FAILURE; HEART RATE VARIABILITY; HOLTER MONITORING; HUMAN; MALE; MORTALITY; PILOT STUDY; QT DISPERSION; RANDOMIZED CONTROLLED TRIAL; SINGLE BLIND PROCEDURE; UNITED KINGDOM;

ACTION POTENTIALS; ADULT; AGED; ALDOSTERONE ANTAGONISTS; ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKERS; CHRONIC DISEASE; CROSS-OVER STUDIES; DOUBLE-BLIND METHOD; DRUG THERAPY, COMBINATION; ELECTROCARDIOGRAPHY, AMBULATORY; FEMALE; HEART FAILURE; HEART RATE; HUMANS; LOSARTAN; MALE; MIDDLE AGED; PILOT PROJECTS; SIGNAL PROCESSING, COMPUTER-ASSISTED; SPIRONOLACTONE; STROKE VOLUME; TIME FACTORS; TREATMENT OUTCOME;

EID: 58149473298     PISSN: 19951892     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (22)

1. Francis GS, Benedict C, Johnstone DE, et al. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure: A substudy of the Studies of Left Ventricular Dysfunction (SOLVD). Circulation 1990; 82: 1724-1729.
2. Dostal DE, Baker KM. Evidence for the role of an intracardiac reninangiotensin system in normal and failing hearts. Trends Cardiovasc Med 1993; 3: 67-74.
3. Spinale FG, de Gasparo M, Whitbran S, et al. Modulation of the renin angiotensin pathway through enzyme inhibition and specific receptor blockade in pacing induced heart failure: Effects on left ventricular performance and neurohormonal systems. Circulation 1997; 96: 2385-2396.
4. Pitt B, Segal R, Martinez FA, Meurers G, Cowley AJ, Thomas I, et al. Evaluation of Losartan in the Elderly Study, ELITE). Lancet 1997; 349: 747-752.
5. Pitt B, Poole-Wilson PA, Segal R, Martinez FA, Dickstein K, Camm AJ, et al. Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial - the Losartan Heart Failure Survival Study ELITE II. Lancet 2000; 6(355): 1582-1587.
6. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325(5): 293-302.
7. McKelvie RS, Yusuf S, Pericak D, et al. Comparison of candesartan, enalapril, and their combination in congestive heart failure: Randomised evaluation of strategies for left ventricular dysfunction (RESOLVD): Circulation 1999; 100: 1056-1064.
8. Swedberg K, Pfeffer M, Granger C, et al. Candesartan in heart failure assessment of reduction in mortality and morbidity (CHARM): Rationale and design. J Cardiac Fail 1999; 5: 276-282.
9. Cohn JN, Tognoni G, Glazer R, Spormann D. Baseline demographics of the Valsartan Heart Failure Trial. Val-HeFT Investigators. Eur J Heart Fail 2000; 2(4): 439-446.
10. Gaudet E, Blanc J, Elghozi JL. Restraining effects of losartan on blood pressure and heart rate variability induced by stress. Fund Clin Pharmacol 1997; 11: 70-74.
11. Weber KT, Brilla CG. Pathological hypertrophy and cardiac interstitium: Fibrosis and renin-angiotensin-aldosterone system. Circulation 1991; 83: 1849-1865.
12. Weber MA, Purdy RE, Drayer JIM. Interactions of mineralocorticoids and pressor agents in vascular smooth muscle. Hypertension 1983; 5: 41-46.
13. Oster JR, Materson BJ. Renal and electrolyte complications of congestive heart failure with angiotensin converting enzyme inhibitors. Arch Intern Med 1992; 152: 704-710.
14. Johnston CI. Tissue angiotensin converting enzyme in cardiac and vascular hypertrophy, repair, and remodelling. Hypertension 1994; 23: 258-268.
15. Struthers AD. Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in chronic heart failure. J Cardiac Fail 1996; 2: 47-54.
16. Brilla CG, Matsubara LS, Weber KT. Anti-aldosterone treatment and the prevention of myocardial fibrosis in primary and secondary hyperaldosteronism. J Molec Cell Cardiol 1993; 25: 563-575.
17. Vanpee D, Swine CH. Elderly heart failure patients with drug-induced serious hyperkalemia. Aging (Milano) 2000; 12(4): 315-319.
18. Barr CS, Lang CC, Hanson J, et al. Effects of adding spironolactone to an ACE inhibitor in chronic congestive heart failure secondary to coronary artery disease. Am J Cardiol 1995; 76: 1259-1265.
19. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999; 341: 709-717.
20. MacFadyen RJ, Barr CS, Struthers AD. Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997; 35(1): 30-34.
21. Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. standards of measurements, physiological interpretation, and clinical use. Circulation 1996; 93: 1043-1065.
22. Yee KM, Pringle SD, Struthers AD. Circadian variation in the effects of aldosterone blockade on heart rate variability and QT dispersion in congestive heart failure. J Am Coll Cardiol 2001; 37(7): 1800-1807.