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[Losartan in therapy of chronic heart failure]
Insights
Losartan effectively treats symptomatic congestive heart failure in ischemic heart disease patients. This nonpeptide angiotensin-2 receptor antagonist improves heart function and reduces adverse cardiac remodeling over 48 weeks.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Symptomatic congestive heart failure (CHF) in patients with ischemic heart disease (IHD) presents significant therapeutic challenges.
- Current treatments aim to manage symptoms and slow disease progression.
Purpose of the Study:
- To evaluate the effectiveness of losartan, a nonpeptide angiotensin-2 subtype-1 receptor antagonist, in treating symptomatic CHF in patients with IHD.
- To assess the impact of losartan on cardiac structure and function over a 48-week period.
Main Methods:
- A randomized controlled trial involving 116 patients (age 36-62) with functional class II-III angina and CHF.
- Patients received either standard therapy or standard therapy plus losartan (25 mg/day) for 48 weeks.
- Echocardiography was used for efficacy monitoring.
Main Results:
- Losartan significantly improved patients' clinical status and heart failure functional class.
- Within 12 weeks, losartan reduced left ventricular and atrial dilation, improving inotropic indices.
- By 48 weeks, losartan halted pathological left ventricular remodeling and prevented decreased myocardial contractility.
Conclusions:
- Losartan demonstrates significant benefits in managing symptomatic CHF in IHD patients.
- Early intervention with losartan (by week 3) shows positive effects in restricting cardiac failure progression.
- Long-term losartan therapy (48 weeks) preserves left ventricular structure and function.
Abstract:
To evaluate effectiveness of nonpeptide angiotensin-2 subtype-1 receptor antagonist losartan in therapy of symptomatic congestive heart failure in patients with ischemic heart disease, 116 patients were examined at the age of 36-62 (mean age 50.6 +/- 4.22). They had angina pectoris of functional class II-III (according to CCS) and congestive heart failure of functional class II-III (according to NYHA). All the patients were randomized into two groups. 60 patients of group 1 received basic medication with nitrates, diuretic (on demand), digoxin and aspirin. 56 patients of group 2 received basic medication and losartan (cozaar, MSD, USA) in the dose 25 mg/day for 48 weeks. Echocardiographic monitoring of the treatment efficacy was made. The outcomes of the treatment evidence that losartan improves the patients' clinical status and heart failure functional class. For twelve weeks losartan reduced left ventricular and atrial dilation positively influencing the isometric inotropic indices. In 48 weeks losartan arrested progression of pathologic remodelling of the left ventricle and prevents depression of total myocardial contractility. Losartan's positive effect in restriction of negative evolution of cardiac failure manifests on the treatment week 3.