Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis: A placebo-controlled, randomized study

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Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis : A placebo-controlled, randomized study. / Dalsgaard, Morten; Iversen, Kasper; Kjaergaard, Jesper; Grande, Peer; Goetze, Jens Peter; Clemmensen, Peter; Hassager, Christian.

I: American Heart Journal, Bind 167, Nr. 2, 02.2014, s. 226-234.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Dalsgaard, M, Iversen, K, Kjaergaard, J, Grande, P, Goetze, JP, Clemmensen, P & Hassager, C 2014, 'Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis: A placebo-controlled, randomized study', American Heart Journal, bind 167, nr. 2, s. 226-234. https://doi.org/10.1016/j.ahj.2013.11.002

APA

Dalsgaard, M., Iversen, K., Kjaergaard, J., Grande, P., Goetze, J. P., Clemmensen, P., & Hassager, C. (2014). Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis: A placebo-controlled, randomized study. American Heart Journal, 167(2), 226-234. https://doi.org/10.1016/j.ahj.2013.11.002

Vancouver

Dalsgaard M, Iversen K, Kjaergaard J, Grande P, Goetze JP, Clemmensen P o.a. Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis: A placebo-controlled, randomized study. American Heart Journal. 2014 feb;167(2):226-234. https://doi.org/10.1016/j.ahj.2013.11.002

Author

Dalsgaard, Morten ; Iversen, Kasper ; Kjaergaard, Jesper ; Grande, Peer ; Goetze, Jens Peter ; Clemmensen, Peter ; Hassager, Christian. / Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis : A placebo-controlled, randomized study. I: American Heart Journal. 2014 ; Bind 167, Nr. 2. s. 226-234.

Bibtex

@article{5b2f1305f8a140df9fcbb32706ae9295,
title = "Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis: A placebo-controlled, randomized study",
abstract = "BACKGROUND: In patients with severe aortic stenosis (AS), treatment with angiotensin-converting enzyme inhibitors has previously been considered contraindicated. However, there is a lack of clinical evidence to confirm these potential hemodynamic risks and benefits.METHODS: Forty-four patients with severe AS (aortic valve area <1 cm(2)) were randomized to treatment with trandolapril 22 mg daily/placebo (1:1). Right heart catheterization and echocardiography were performed at rest and during exercise at baseline and on day 3. Follow-up was performed before valve replacement or after a maximum of 8 weeks, when exercise echocardiography was repeated.RESULTS: Compared with placebo, systolic blood pressure and systemic arterial compliance significantly changed at day 3 (-14 ± 11 vs -5 ± 13 mm Hg, P = .02, and 0.08 ± 0.16 vs -0.05 ± 0.86 mL/m(2) per mm Hg, P = .03, respectively). Changes in left ventricular end systolic volume (LVESV) was nonsignificant (-8 ± 9 vs -3 ± 11 mL, P = .17). At a median of 49 days of follow-up, changes in LVESV and N-terminal pro-brain natriuretic peptide were even lower revealing significant differences between the groups (-7.8 ± 2.6 vs -0.5 ± 2.5 mL, P = .04, and -19 ± 7 vs 0.8 ± 6 pmol/L, P = .04, respectively). No episodes of symptomatic hypotension were noted, and other hemodynamic parameters remained unchanged.CONCLUSION: Angiotensin-converting enzyme inhibition in severe AS caused a decrease in LVESV and N-terminal pro-brain natriuretic peptide with other hemodynamic parameters preserved both at rest and during exercise implying hemodynamic improvement with left ventricular unloading.",
keywords = "Aged, Aged, 80 and over, Angiotensin-Converting Enzyme Inhibitors, Aortic Valve Stenosis, Dose-Response Relationship, Drug, Double-Blind Method, Echocardiography, Exercise Test, Female, Follow-Up Studies, Hemodynamics, Humans, Indoles, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome",
author = "Morten Dalsgaard and Kasper Iversen and Jesper Kjaergaard and Peer Grande and Goetze, {Jens Peter} and Peter Clemmensen and Christian Hassager",
note = "{\circledC} 2014.",
year = "2014",
month = "2",
doi = "10.1016/j.ahj.2013.11.002",
language = "English",
volume = "167",
pages = "226--234",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "2",

}

RIS

TY - JOUR

T1 - Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis

T2 - A placebo-controlled, randomized study

AU - Dalsgaard, Morten

AU - Iversen, Kasper

AU - Kjaergaard, Jesper

AU - Grande, Peer

AU - Goetze, Jens Peter

AU - Clemmensen, Peter

AU - Hassager, Christian

N1 - © 2014.

PY - 2014/2

Y1 - 2014/2

N2 - BACKGROUND: In patients with severe aortic stenosis (AS), treatment with angiotensin-converting enzyme inhibitors has previously been considered contraindicated. However, there is a lack of clinical evidence to confirm these potential hemodynamic risks and benefits.METHODS: Forty-four patients with severe AS (aortic valve area <1 cm(2)) were randomized to treatment with trandolapril 22 mg daily/placebo (1:1). Right heart catheterization and echocardiography were performed at rest and during exercise at baseline and on day 3. Follow-up was performed before valve replacement or after a maximum of 8 weeks, when exercise echocardiography was repeated.RESULTS: Compared with placebo, systolic blood pressure and systemic arterial compliance significantly changed at day 3 (-14 ± 11 vs -5 ± 13 mm Hg, P = .02, and 0.08 ± 0.16 vs -0.05 ± 0.86 mL/m(2) per mm Hg, P = .03, respectively). Changes in left ventricular end systolic volume (LVESV) was nonsignificant (-8 ± 9 vs -3 ± 11 mL, P = .17). At a median of 49 days of follow-up, changes in LVESV and N-terminal pro-brain natriuretic peptide were even lower revealing significant differences between the groups (-7.8 ± 2.6 vs -0.5 ± 2.5 mL, P = .04, and -19 ± 7 vs 0.8 ± 6 pmol/L, P = .04, respectively). No episodes of symptomatic hypotension were noted, and other hemodynamic parameters remained unchanged.CONCLUSION: Angiotensin-converting enzyme inhibition in severe AS caused a decrease in LVESV and N-terminal pro-brain natriuretic peptide with other hemodynamic parameters preserved both at rest and during exercise implying hemodynamic improvement with left ventricular unloading.

AB - BACKGROUND: In patients with severe aortic stenosis (AS), treatment with angiotensin-converting enzyme inhibitors has previously been considered contraindicated. However, there is a lack of clinical evidence to confirm these potential hemodynamic risks and benefits.METHODS: Forty-four patients with severe AS (aortic valve area <1 cm(2)) were randomized to treatment with trandolapril 22 mg daily/placebo (1:1). Right heart catheterization and echocardiography were performed at rest and during exercise at baseline and on day 3. Follow-up was performed before valve replacement or after a maximum of 8 weeks, when exercise echocardiography was repeated.RESULTS: Compared with placebo, systolic blood pressure and systemic arterial compliance significantly changed at day 3 (-14 ± 11 vs -5 ± 13 mm Hg, P = .02, and 0.08 ± 0.16 vs -0.05 ± 0.86 mL/m(2) per mm Hg, P = .03, respectively). Changes in left ventricular end systolic volume (LVESV) was nonsignificant (-8 ± 9 vs -3 ± 11 mL, P = .17). At a median of 49 days of follow-up, changes in LVESV and N-terminal pro-brain natriuretic peptide were even lower revealing significant differences between the groups (-7.8 ± 2.6 vs -0.5 ± 2.5 mL, P = .04, and -19 ± 7 vs 0.8 ± 6 pmol/L, P = .04, respectively). No episodes of symptomatic hypotension were noted, and other hemodynamic parameters remained unchanged.CONCLUSION: Angiotensin-converting enzyme inhibition in severe AS caused a decrease in LVESV and N-terminal pro-brain natriuretic peptide with other hemodynamic parameters preserved both at rest and during exercise implying hemodynamic improvement with left ventricular unloading.

KW - Aged

KW - Aged, 80 and over

KW - Angiotensin-Converting Enzyme Inhibitors

KW - Aortic Valve Stenosis

KW - Dose-Response Relationship, Drug

KW - Double-Blind Method

KW - Echocardiography

KW - Exercise Test

KW - Female

KW - Follow-Up Studies

KW - Hemodynamics

KW - Humans

KW - Indoles

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Severity of Illness Index

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1016/j.ahj.2013.11.002

DO - 10.1016/j.ahj.2013.11.002

M3 - Journal article

C2 - 24439984

VL - 167

SP - 226

EP - 234

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 2

ER -

ID: 138173469