The Effect of Rennin-Angiotensin Blockers on Ejection Fraction in Patients with Left Ventricular Systolic Dysfunction Heart Failure
Introduction:Left ventricular systolic dysfunction (LVSD) is a type of heart failure characterized by low ejection fraction (EF) and increase in mortality and morbidity. Rennin- Angiotensin Blockers are confirmed to improve EF and quality of life in patients with LVSD.
Objective:The aim of this study was to assess and compare the effect of rennin angiotensin blockers on EF in patient with LVSD.
Methodology:80 patients with LVSD were assigned to use either ACEI (lisinopril) or ARBS (losartan or candesartan); patient’s clinical data and Echocardiography had been followed for 6 months.
Results:There was improvement on EF; by 9% in the group taking ACEI (lisinopril) and by 8% in the group taking ARBS. 52.6% of patients showed improvement in their QOL.
Conclusion:There is an improvement on the EF% in the ARBS (losartan or candesartan) group as well as the ACEI (lisinopril) group. There was no significant difference when comparing the effect of the 2 groups of drugs on the EF%. The quality of life improved in most patients with treatment with these drugs.
2. Mary A Koda-Kimble, Lloyd Y Young, Wayne A Kradjan, and B. Joseph Guglielmo, Applied therapeutics, p171-2.
3. Rev. Latino-am Enfermagem. Quality of life of coronary artery disease patients after the implemention of planning strategies for medication adherence .2015;23(1).9-11.
4. Eva Lonn, Robert McKelvie, Drug treatment in heart failure, British Medical Journal 2000; 320; 1188-1192.
5. Effects of enalapril on mortality in sever congestive heart failure. The Cooperative North Scandinavian Enalapril Survival Study CONSENSUS.N Eng J Med 1987; 316:1429–35.
6. The Study of Left Ventricular Dysfunction (SOLVD) Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure. N Engl J Med 1991; 325:293-¬302.
7. John J V McMurray, Jan Östergren, et al. Effects of candesartan in patients with chronic heart failure and reduced left ventricular systolic function taking angiotensin converting enzyme inhibitors: the CHARM-Added trial. The LANCET2003; 362:767-771.
8. Christopher B Granger, John J V McMurray, Salim Yusuf, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial, The LANCET2003; 362:772-76.
9. Hermann F, Ruschitzka Ft, Schiffin EL, et al. Effects of candesartan in patients with chronic heart failure and preserved left -ventricular ejection fraction: the CHARM-Preserved trial. The LANCET 2003; 362:777-81.
10. Young J, Swedberg K, Dunlap ME, et al. Substantial reduction in all-cause mortality and morbidity with candesartan in patients with chronic heart failure and systolic left ventricular dysfunction: results of the CHARM low EF trials. Eur Heart J. 2004; 25(suppl):487. Abstract 2916.
11. Pitt B, Segal R, Martinez FA, et al. Randomized trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly, ELITE). The Lancet 1997; 349:747–752.
12. Witherow FN, Helmy A, Webb DJ, et al. Bradykinin contributes to thevasodilator effects of chronic angiotensin-converting enzyme inhibition in patients with heart failure. Circulation 2001; 104: 2177–81.
13. Witherow FN, Dawson P, Ludlam CA, et al. Marked bradykinin induced tissue plasminogen activator release in patients with heart failure maintained on long-term angiotensin-converting enzyme inhibitor therapy. J Am Coll Cardiol 2002; 40: 961–66.
14. Sabu Thomas, Edward geltman, et al. The optimal dose of ACEI in HF, Landmark trial, CHF le jacq 2006; 12:213-18.
15. C R Gibbs, M K Davies, et al. The ABC of heart failure, Student BMJ 2000; 08:175-216.