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Pulsatile hemodynamic effects of candesartan in patients with chronic heart failure: the CHARM Program

Gary F Mitchell1, J Malcolm O Arnold, Mark E Dunlap

  • 1Cardiovascular Engineering, Inc., 327 Fiske Street, Holliston, MA 01746, USA. GaryFMitchell@mindspring.com

European Journal of Heart Failure
|September 29, 2005
PubMed

Insights

Candesartan improved large artery function in patients with chronic heart failure (CHF). The AT1 receptor blocker reduced central pulse pressure, characteristic impedance, and increased arterial compliance.

Area of Science:

  • Cardiology
  • Vascular Physiology
  • Pharmacology

Background:

  • Abnormal large artery function and increased pulsatile load worsen chronic heart failure (CHF).
  • Excess angiotensin-II acting via the AT1 receptor exacerbates these issues in CHF pathogenesis.

Purpose of the Study:

  • To evaluate the effects of candesartan, an AT1 receptor blocker, versus placebo on pulsatile hemodynamics in CHF patients.
  • Assess changes in central hemodynamics and arterial function over 14 months.

Main Methods:

  • Noninvasive hemodynamics assessed using calibrated tonometry and aortic outflow Doppler.
  • Characteristic impedance and total arterial compliance calculated.
  • Comparison between candesartan (N=30) and placebo (N=34) groups.

Main Results:

  • Candesartan significantly reduced central pulse pressure (P=0.043) and characteristic impedance (P=0.039).
  • Total arterial compliance was significantly increased with candesartan (P=0.008).
  • No differences in brachial blood pressure, cardiac output, or peripheral resistance were observed.

Conclusions:

  • Candesartan demonstrates a favorable effect on large artery function in patients with chronic heart failure.
  • These hemodynamic improvements suggest a potential benefit for managing CHF progression.
Abstract

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