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Losartan treatment and left ventricular filling during volume loading in patients with dilated cardiomyopathy

Letizia Spinelli1, Mario Petretta, Maria L E Vicario

  • 1Department of Internal Medicine, University of Naples, Frederico II, 80131 Naples, Italy.

American Heart Journal
|February 28, 2002
PubMed

Insights

Volume expansion enhances early left ventricular (LV) filling in healthy individuals but increases filling pressures in dilated cardiomyopathy (DCM) patients. Losartan improves diastolic adaptation to volume loading in DCM.

Area of Science:

  • Cardiology
  • Physiology
  • Medical Research

Background:

  • Mild heart failure patients exhibit reduced preload reserve during volume expansion.
  • Effects of volume expansion on left ventricular (LV) diastolic filling in mild heart failure remain unclear.

Purpose of the Study:

  • To evaluate acute volume loading effects on Doppler parameters of LV filling.
  • To investigate losartan's impact on diastolic adaptation to volume load in idiopathic dilated cardiomyopathy (DCM) patients.

Main Methods:

  • Assessed Doppler parameters of LV filling in 10 healthy controls and 12 DCM patients during acute volume loading.
  • Investigated the effects of losartan on diastolic adaptation in DCM patients.

Main Results:

  • Healthy subjects showed improved LV filling rates and pulmonary venous flow post-volume loading.
  • DCM patients exhibited altered LV relaxation and filling patterns, with pulmonary venous flow reversal exceeding mitral flow.
  • Losartan treatment normalized these altered patterns in DCM patients.

Conclusions:

  • Healthy individuals enhance early LV filling with volume load; DCM patients experience increased LV filling pressures.
  • Losartan improves diastolic adaptation to volume loading in DCM patients.
Abstract

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