Beneficial effects of ramipril on left ventricular end-diastolic and end-systolic volume indexes after uncomplicated invasive revascularization are associated with a reduction in cardiac events in patients with moderately impaired left ventricular function and no clinical heart failure

The antihypertensive and haemodynamic efficacies of ketanserin and ketanserin plus enalapril were compared. The monotherapy phase of the study involved the oral administration of 40 mg ketanserin twice daily or 20 mg enalapril once daily for 12 weeks to 25 hypertensive patients. Systolic and diastolic blood pressures were significantly reduced by both drugs. Left ventricular function both at rest and during effort improved significantly with either drug. This was due to a reduction of end-systolic volume; end-diastolic volume decreased only with the use of enalapril. Combination therapy, involving 16 patients and both drugs given at the original dosage schedule for 12 weeks, resulted in further reductions in systolic and diastolic blood pressures, and an improvement in left ventricular function; indices of diastolic function were not modified. In conclusion, ketanserin and enalapril showed comparable antihypertensive and haemodynamic activities. A combination of ketanserin and enalapril increased the favourable characteristics of both drugs.

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Significance of left ventricular global longitudinal strain assessment in patients with preserved ejection fraction after acute myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1212 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

B Luvsansuren ◽

S Chimed

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Ejection Fraction ◽

Left Ventricular Function ◽

Ventricular Function ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Clinical Heart Failure

Abstract Background Depression of left ventricular function is common phenomenon after acute myocardial infarction and it's often associated with poor prognosis. However, substantial portion of patients with acute myocardial infarction had normal left ventricular function by assessment of left ventricular ejection fraction. Purpose In this study, we examined role of left ventricular global longitudinal strain assessment in patients who had normal ejection fraction after acute myocardial infarction. Methods We choose patients with acute myocardial infarction who were successfully treated with primary percutaneous coronary intervention (PCI). All of those patients had normal ejection fraction (EF≥55%) in routine echocardiographic examination within 3 days after acute myocardial infarction. Two dimensional speckle tracking echocardiography was used to assess left ventricular global longitudinal strain. Based on existence of newly onset clinical signs (pulmonary edema, lung crackles, peripherial edema etc.) of heart failure patients divided into case and control group. Patients who had other etiology or previous heart failure were excluded. Results A total of 153 patients with AMI were selected and newly onset heart failure is occurred in 20 patients. Left ventricular global strain was significantly different between patients with clinical heart failure and patients without clinical heart failure (−11.1±1.85% vs. −16.6±3.38%, p<0.001). After adjustment of possible predictors of impaired left ventricular function such as, age, gender, hypertension, diabetes, previous coronary artery disease, cardiac troponin, mitral inflow EA ratio, deceleration time, left ventricular end diastolic volume, ejection fraction, mitral annulus EE' ratio and wall motion score index, global longitudinal strain was independent predictor of clinical heart failure (odds ratio 1.79, 95% CI 1.22–2.65, p=0.003). Adding global longitudinal strain into above mentioned predictors of clinical heart failure after acute myocardial infarction is associated with significantly increased c-statistic (0.93, 95% CI 0.87–0.99 vs. 0.97, 95% CI 0.94–0.99, p<0.001). Conclusion Left ventricular global longitudinal strain is independently associated with clinical heart failure in patients with preserved ejection fraction after acute myocardial infarction. Adding global longitudinal strain parameter into screening model may increase rate of precise determination of clinical heart failure after acute myocardial infarction. Funding Acknowledgement Type of funding source: None

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Darbepoetin-α prevents progressive left ventricular dysfunction and remodeling in nonanemic dogs with heart failure

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00074.2008 ◽

2008 ◽

Vol 295 (6) ◽

pp. H2475-H2482 ◽

Cited By ~ 8

Author(s):

Sharad Rastogi ◽

Makoto Imai ◽

Victor G. Sharov ◽

Sudhish Mishra ◽

Hani N. Sabbah

Keyword(s):

Heart Failure ◽

Caspase 3 ◽

Hypoxia Inducible Factor ◽

Left Ventricular ◽

Stem Cell Marker ◽

Lv Function ◽

Systolic Volume ◽

Beneficial Effects ◽

End Diastolic Volume ◽

End Systolic Volume

In anemic patients with heart failure (HF), erythropoietin-type drugs can elicit clinical improvement. This study examined the effects of chronic monotherapy with darbepoetin-α (DARB) on left ventricular (LV) function and remodeling in nonanemic dogs with advanced HF. HF [LV ejection fraction (EF) ∼25%] was produced in 14 dogs by intracoronary microembolizations. Dogs were randomized to once a week subcutaneous injection of DARB (1.0 μg/kg, n = 7) or to no therapy (HF, n = 7). All procedures were performed during cardiac catheterization under general anesthesia and under sterile conditions. LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF were measured before the initiation of therapy and at the end of 3 mo of therapy. mRNA and protein expression of caspase-3, hypoxia inducible factor-1α, and the bone marrow-derived stem cell marker c-Kit were determined in LV tissue. In HF dogs, EDV and ESV increased and EF decreased after 3 mo of followup. Treatment with DARB prevented the increase in EDV, decreased ESV, and increased EF. DARB therapy also normalized the expression of HIF-1α and active caspase-3 and enhanced the expression of c-Kit. We conclude that chronic monotherapy with DARB prevents progressive LV dysfunction and dilation in nonanemic dogs with advanced HF. These results suggest that DARB elicits beneficial effects in HF that are independent of the presence of anemia.

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