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Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension
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Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension

Published on: March 17, 2022

Safety and efficiency of chronic ACE inhibition in symptomatic heart failure patients with a systemic right ventricle

Oktay Tutarel1, Gerd Peter Meyer, Harald Bertram

  • 1Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. Tutarel.Oktay@MH-Hannover.de

International Journal of Cardiology
|September 17, 2010
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibition safely reduces NT-proBNP levels in adults with heart failure after the Mustard procedure. This treatment shows promise for managing heart failure symptoms in this specific patient population.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Heart Failure Management

Background:

  • Congestive heart failure (CHF) management often involves ACE inhibition for left ventricular dysfunction.
  • Limited data exists on ACE inhibition's efficacy in adults with heart failure post-Mustard procedure for transposition of the great arteries (TGA).

Purpose of the Study:

  • To investigate the effects of ACE inhibition on heart failure symptoms, echocardiographic parameters, NT-proBNP levels, and exercise capacity in adult patients post-Mustard procedure.
  • To assess the safety and efficacy of ACE inhibition in this unique patient cohort.

Main Methods:

  • A cohort of 14 adult patients (mean age 25.2 years) who underwent the Mustard procedure for TGA and presented with NYHA class II heart failure received enalapril.
  • Echocardiography, exercise testing, and NT-proBNP measurements were conducted at baseline and after 13.3 months of treatment.
  • A comparison was made with an age- and sex-matched control group.

Main Results:

  • While maximum oxygen uptake and echocardiographic parameters showed no significant changes, NT-proBNP levels significantly decreased in the enalapril treatment group (242 to 151 ng/l).
  • Conversely, NT-proBNP levels significantly increased in the control group (120 to 173 ng/l).
  • ACE inhibitor treatment did not lead to worsening heart failure symptoms or compromised renal function.

Conclusions:

  • ACE inhibitor therapy is safe for managing heart failure symptoms in patients with a systemic right ventricle post-Mustard procedure.
  • Treatment significantly reduces NT-proBNP levels, indicating a reduction in ventricular overload.
  • Larger trials are needed to establish definitive effects on morbidity and mortality in this specialized population.
Abstract

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