Related Experiment Video

Updated: Aug 15, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Amlodipine monotherapy, angiotensin-converting enzyme inhibition, and combination therapy with pacing-induced heart

S B Kribbs1, W M Merritt, M J Clair

  • 1Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425-2279, USA.

Hypertension (Dallas, Tex. : 1979)
|March 12, 1998
PubMed

Insights

This study shows that combining amlodipine and ACE inhibitors improves congestive heart failure (CHF) more than either drug alone. Combination therapy offers greater benefits for vascular resistance and neurohormonal activity in CHF patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Physiology

Background:

  • Congestive heart failure (CHF) is a complex condition affecting cardiac function.
  • Angiotensin-converting enzyme (ACE) inhibition is a standard therapy for CHF.
  • Calcium channel blockers, like amlodipine, have shown potential benefits in CHF patients on ACE inhibitors.

Purpose of the Study:

  • To investigate the mechanisms behind amlodipine's favorable effects in CHF.
  • To compare amlodipine monotherapy with combination therapy with ACE inhibition.
  • To assess left ventricular function, hemodynamics, and neurohormonal activity in a porcine CHF model.

Main Methods:

  • Thirty-two pigs were subjected to rapid atrial pacing to induce CHF.
  • Four treatment groups were established: pacing only, amlodipine + pacing, ACE inhibition + pacing, and amlodipine + ACE inhibition + pacing.
  • Cardiac index, total systemic resistance index, and neurohormonal markers (catecholamines, renin, endothelin) were measured.

Main Results:

  • Both amlodipine and ACE inhibition monotherapy improved cardiac index compared to pacing alone.
  • Combination therapy normalized total systemic resistance index, outperforming monotherapies.
  • Combination therapy demonstrated superior effects on neurohormonal activity, reducing norepinephrine and normalizing epinephrine levels.

Conclusions:

  • Monotherapy with amlodipine or ACE inhibition provides benefits in this CHF model.
  • Combined amlodipine and ACE inhibition therapy offers greater advantages in managing vascular resistance and neurohormonal imbalances in CHF.
  • This study elucidates the synergistic effects of amlodipine and ACE inhibitors in a preclinical CHF model.

More Related Videos

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models07:49

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models

Published on: July 21, 2023

Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...