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The acute effect of ACEI and ARB's upon endothelin in heart failure patients

D Zdrenghea1, Dana Pop, G Bodizs

  • 1Cardiology Department, Rehabilitation Clinical Hospital, Cluj-Napoca, Romania. dzdrenghea@hotmail.com

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|November 9, 2004
PubMed

Insights

Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) effectively reduce endothelin levels in heart failure patients. Both drug classes demonstrated similar efficacy in this acute study.

Area of Science:

  • Cardiology
  • Pharmacology
  • Endocrinology

Background:

  • Heart failure is a complex condition often associated with neurohormonal imbalances.
  • Endothelin, a potent vasoconstrictor, plays a significant role in the pathophysiology of heart failure.
  • ACE inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are cornerstone therapies for heart failure, targeting the renin-angiotensin-aldosterone system.

Purpose of the Study:

  • To compare the acute effects of ACEI and ARB on plasma endothelin levels in patients with heart failure.
  • To evaluate the comparative efficacy of a single dose of trandolapril (ACEI) versus telmisartan (ARB) on endothelin reduction.

Main Methods:

  • A study involving 30 patients with NYHA class III-IV congestive heart failure, treatment-naïve to ACEI or ARB.
  • Baseline plasma endothelin 1-21 levels were measured.
  • Patients received either trandolapril (n=20) or telmisartan (n=10), with endothelin levels re-assessed after 24 hours.

Main Results:

  • Both ACEI (trandolapril) and ARB (telmisartan) significantly decreased plasma endothelin levels within 24 hours (p<0.05 for both groups).
  • The initial endothelin levels were inversely correlated with left ventricular ejection fraction (LVEF).
  • The magnitude of endothelin reduction was directly correlated with the initial endothelin level.

Conclusions:

  • Acute administration of both ACEI and ARB effectively reduces plasma endothelin levels in heart failure patients.
  • ACEI and ARB exhibit comparable efficacy in lowering endothelin in the acute setting.
  • These findings highlight the role of endothelin modulation in the therapeutic effects of ACEI and ARB in heart failure.
Abstract

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