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Correlation between fibronectin and cardiothoracic ratio in heart failure treated with angiotensin converting enzyme
N Olinic1, L Vida-Simiti, A Cristea
1Medical Clinic no. 1, Cluj-Napoca, Romania.
Insights
Angiotensin converting enzyme (ACE) inhibitors significantly increased fibronectin levels and decreased cardiothoracic ratio in heart failure patients. This suggests fibronectin may indicate positive effects of ACE inhibitors on heart tissue.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Ischemic heart disease with left ventricular dilatation and congestive heart failure (NYHA class III-IV) presents significant challenges.
- Standard treatments include diuretics, digitalis, and nitrates, but further therapeutic strategies are explored.
Purpose of the Study:
- To investigate the effect of angiotensin converting enzyme (ACE) inhibitors on fibronectin levels and cardiac structure in patients with heart failure.
- To determine if changes in fibronectin correlate with improvements in cardiac parameters.
Main Methods:
- Seventeen patients with ischemic heart disease and heart failure received captopril or perindopril in addition to standard therapy.
- Plasmatic fibronectin levels were measured using radial immunodiffusion before and after one month of ACE inhibitor treatment.
- Cardiothoracic ratio was assessed as an indicator of cardiac size.
Main Results:
- A significant increase in plasmatic fibronectin levels was observed after one month of ACE inhibitor therapy (p < 0.001).
- A significant decrease in cardiothoracic ratio was noted concurrently (p < 0.02).
- A positive correlation (r = 0.62; p < 0.01) was found between increased fibronectin and decreased cardiothoracic ratio.
Conclusions:
- ACE inhibitors significantly impact fibronectin levels and cardiac dimensions in heart failure patients.
- Elevated fibronectin may serve as a biomarker for the beneficial effects of ACE inhibitors on the cardiac interstitium.
Abstract:
A group of 17 patients with ischemic heart disease, significant left ventricular dilatation and congestive heart failure, class III NYHA (9 patients) and class IV NYHA (8 patients) was studied. The patients received angiotensin converting enzyme inhibitor--captopril 75 mg/day or perindopril 4 mg/day--added to diuretics, digitalis and nitrates. The plasmatic level of fibronectin was investigated, by radial immunodiffusion, before and one month after the beginning of the treatment with angiotensin converting enzyme (ACE) inhibitor. The plasmatic level of fibronectin is increased significantly (p < 0.001) while the cardiothoracic ratio is decreased significantly (p < 0.02) after one month of ACE inhibitors treatment. A positive correlation between the increase of the plasmatic level of fibronectin and the decrease of cardiothoracic ratio is found (r = 0.62; p < 0.01). The increased fibronectin plasmatic level can be a marker of the favorable effect of ACE inhibitor on the myocardium interstitium.