scholarly journals Effects of combination of AT1-antagonist candesartan cilexetil and ACE-inhibitors in patients with congestive heart failure

2013 ◽  
Vol 141 (1-2) ◽  
pp. 29-34
Author(s):  
Edis Gasanin ◽  
Ivana Dragutinovic ◽  
Dragic Bankovic ◽  
Veselin Mitrovic
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Placebo Group ◽  
Ace Inhibitors ◽  
Candesartan Cilexetil ◽  
Nyha Class ◽  
Right Atrial ◽  
Double Blind ◽  
At1 Antagonist ◽  
Significant Difference

Introduction. Combination of ACE-inhibitors with angiotensin-II type 1 receptor antagonists could provide better blockade of RAAS system compared with monotherapy. Objective. The aim of this study was to evaluate hemodynamic and neurohumoral effects at rest and during exercise of Candesartan cilexetil as add-on therapy to ACE-inhibitors in patients with heart failure NYHA class III to IV. Methods. This was a prospective, randomized, double-blind, placebo-controlled, parallel group study. Thirty-five patients received either Candesartan 8 mg/16 mg (1st and 2nd week/ of 3-24) or placebo as add-on therapy to their previous ACE-inhibitor during a 24-weeks treatment period. Results. Peak aerobic capacity remained constant in the Candesartan group of patients (0.06?1.43 mL/min/ kg) and slightly decreased in the placebo group (-1.10?1.51 mL/min/kg), without a statistically significant difference between the groups (p=0.13). Exercise time showed a relevant increase in the Candesartan (31.9?58.5 sec) and a significant decrease in the placebo group (-25.9?85.9 sec) compared to baseline value. The difference between the studied groups was statistically significant (p<0.001). Relevant differences between the two groups were observed in the changes of right atrial pressure at rest (Candesartan: -1.9?1.7 mmHg, placebo: 1.0?2.7 mmHg, p<0.01), pulmonary capillary wedge pressure at rest (Candesartan: -3.1?3.8 mmHg, placebo: 0.2?4.6 mmHg, p<0.05) and systemic vascular resistance at maximum exercise (Candesartan: -141.9?253.3 dyne sec/cm5, placebo: 47.3?221.0 dyne sec/cm5, p<0.05). Conclusion. The efficacy of CHF treatment of congestive heart failure was moderately improved by Candesartan as add-on therapy to ACE-inhibitors.

scholarly journals Degenerative Pathology of the Ankle, Hindfoot, and Midfoot is as Limiting to Patient Mobility as Congestive Heart Failure

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0016
Author(s):  
Amalie Erwood ◽  
Gregory Kurkis ◽  
Samuel David Maidman ◽  
Robert Cole ◽  
Shay Ariel Tenenbaum ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Nyha Class ◽  
Class Ii ◽  
Study Patient ◽  
Foot And Ankle ◽  
Ankle Arthritis ◽  
Patient Mobility ◽  
Patient Demographics ◽  
Significant Difference

Category: Ankle, Ankle Arthritis, Hindfoot, Midfoot/Forefoot Introduction/Purpose: Degenerative conditions of the ankle, hindfoot, and midfoot can markedly limit mobility. The Life-Space Assessment (LSA) is a questionnaire quantifying how patients mobilize after a medical event as they return to their previous daily settings. Current outcome measures do not accurately assess mobility in the geriatric foot and ankle population. In contrast, the effect of congestive heart failure (CHF) on patient mobility is routinely assessed via the New York Heart Association (NYHA) functional classification. The NYHA classification is stratified by limitation of physical activity: I (no limitation), II (some limitation), III (marked limitation), and IV (unable to carry out without discomfort). We hypothesized that degenerative conditions of the foot and ankle would be as mobility limiting as CHF. Methods: Patients over the age of 50 were included in this study. LSA data was prospectively collected from patients with degenerative ankle, hindfoot, and midfoot diagnoses at their preoperative visit and NYHA-classified CHF patients at a cardiology clinic. The degenerative foot and ankle cohort included Achilles tendonitis, ankle joint cartilage defects, ankle arthritis, subtalar arthritis, and midfoot arthritis. Patient demographics and comorbidities were recorded from the electronic medical record. Mean LSA data was analyzed and compared using a Student’s t-test. Results: 28 degenerative foot and ankle patients and 44 CHF patients met inclusion criteria for the study. Patient demographics, including age, gender, and BMI, were not significantly different between the two groups. The foot and ankle cohort had a mean LSA score of 68. Mobility of the foot and ankle group was significantly less compared to NYHA class I patients, who had a LSA score of 103 (p=0.008). There was no significant difference in mobility compared to class II or III congestive heart failure patients, who recorded a mean LSA score of 62 (p=0.60). There was insufficient data available on NYHA class IV patients to make comparisons to this group. Conclusion: Degenerative ankle, hindfoot, and midfoot pathology is associated with similar mobility limitation to that of NYHA class II and III congestive heart failure.

scholarly journals COMPARISON OF CONCENTRATION DIFFERENCE BETWEEN ST2 DAN NT-PRO BNP BEFORE AND AFTER ACE-INHIBITORS IN NYHA III-IV HEART FAILURE PATIENTS

2019 ◽  
Vol 26 (1) ◽  
pp. 11
Author(s):  
Veronika Juanita Maskito
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Ace Inhibitors ◽  
Nyha Class ◽  
Sandwich Elisa ◽  
Clinical Signs ◽  
Concentration Difference ◽  
Heart Failure Patients ◽  
Significant Difference ◽  
Before And After

Background: The American Heart Association (2016) stated that at the age of forty the risk of developing heart failure is one in five. Medication is based on clinical signs and symptoms that are often late. Early cardiac markers are required to guide therapy. This study compared the difference between ST2 and NT-ProBNP concentrations before and after ACE inhibitors (ACE-I) in NYHA III-IV heart failure patients.Method: This was a randomized prospective observational study without controls. The respondents were males or females, 21-75 y.o in NYHA III-IV heart failure patients. Twenty-five respondents were appropriate to inclusion criteria. The ST2 was measured by Quantikine®ST2/IL-33R quantitative sandwich ELISA immunoassay while NT-proBNP was measured by Immulite Turbo® 1000.Result: Majority of respondents were males (60%) and had  comorbidities(60,7%), consisting of NYHA Class III(36%) and IV(64%). Coronary artery disease and valvular heart disease (40%,36% respectively). Length of stay was 6.4±3.4days. The concentration difference of ST2 and NT-proBNP before and after ACE-I were both significant, however, NT-proBNP was more significant (p=0,001 vs p=0,023). NYHA at admission influenced ST2 difference but not NT-proBNP. NT-proBNP concentration correlated to length of stay while ST2 was not. ST2 had negative correlation with age, no correlation to GFR and weight. NT-proBNP was correlated to weight, negatively correlated to GFR, not correlated to age. ACE-I subtypes difference did not affect the study result.Conclusion: NT-proBNP was a better heart failure cardiac marker than ST2 due to its ability in diagnosis, prognosis and showing more significant difference after ACE-I administration.

scholarly journals Effects of Fermented Milk Containing Lacticaseibacillus paracasei Strain Shirota on Constipation in Patients with Depression: A Randomized, Double-Blind, Placebo-Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2238
Author(s):  
Xiaomei Zhang ◽  
Shanbin Chen ◽  
Ming Zhang ◽  
Fazheng Ren ◽  
Yimei Ren ◽  
...  
Keyword(s):  
Mental Illness ◽  
Placebo Group ◽  
Rating Scale ◽  
Controlled Trial ◽  
Fermented Milk ◽  
Daily Consumption ◽  
Double Blind ◽  
Tnf Α ◽  
Significant Difference ◽  
Factor Α

Probiotics have been shown to benefit patients with constipation and depression, but whether they specifically alleviate constipation in patients with depression remains unclear. The aim of this study was to investigate the effect of Lacticaseibacillus paracasei strain Shirota (LcS), formerly Lactobacillus casei strain Shirota, on constipation in patients with depression with specific etiology and gut microbiota and on depressive regimens. Eighty-two patients with constipation were recruited. The subjects consumed 100 mL of a LcS beverage (108 CFU/mL) or placebo every day for 9 weeks. After ingesting beverages for this period, we observed no significant differences in the total patient constipation-symptom (PAC-SYM) scores in the LcS group when compared with the placebo group. However, symptoms/scores in item 7 (rectal tearing or bleeding after a bowel movement) and items 8–12 (stool symptom subscale) were more alleviated in the LcS group than in the placebo group. The Beck Depression Index (BDI) and Hamilton Depression Rating Scale (HAMD) scores were all significantly decreased, and the degree of depression was significantly improved in both the placebo and LcS groups (p < 0.05), but there was no significant difference between the groups. The LcS intervention increased the beneficial Adlercreutzia, Megasphaera and Veillonella levels and decreased the bacterial levels related to mental illness, such as Rikenellaceae_RC9_gut_group, Sutterella and Oscillibacter. Additionally, the interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) levels were significantly decreased in both the placebo and LcS groups (p < 0.05). In particular, the IL-6 levels were significantly lower in the LcS group than the placebo group after the ingestion period (p < 0.05). In conclusion, the daily consumption of LcS for 9 weeks appeared to relieve constipation and improve the potentially depressive symptoms in patients with depression and significantly decrease the IL-6 levels. In addition, the LcS supplementation also appeared to regulate the intestinal microbiota related to mental illness.

scholarly journals Angiotensin receptor antagonist improves cardiac reflex control of renal sodium handling in heart failure

1998 ◽  
Vol 274 (2) ◽  
pp. H636-H641 ◽  
Author(s):  
Gerald F. Dibona ◽  
Susan Y. Jones ◽  
Linda L. Sawin
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Right Atrial ◽  
Nerve Activity ◽  
Renal Sympathetic Nerve Activity ◽  
Renal Sympathetic Nerve ◽  
Renal Sodium Handling ◽  
Renal Sympathetic

In rats with congestive heart failure, type 1 angiotensin II receptor antagonist treatment (losartan) decreases basal renal sympathetic nerve activity and improves arterial baroreflex regulation of renal sympathetic nerve activity. This investigation examined the effect of losartan on cardiac baroreflex regulation of renal sympathetic nerve activity and renal sodium handling in rats with congestive heart failure. Losartan treatment decreased arterial pressure from 120 ± 3 to 93 ± 5 mmHg and increased the afferent (from 0.95 ± 0.21 to 2.22 ± 0.42% Δafferent vagal nerve activity/mmHg mean right atrial pressure, P < 0.05) and overall gain (from −1.14 ± 0.19 to −4.20 ± 0.39% Δrenal sympathetic nerve activity/mmHg mean right atrial pressure, P < 0.05) of the cardiac baroreflex. During isotonic saline volume loading, urinary sodium excretion increased from 2.4 ± 0.8 to 10.5 ± 1.3 μeq/min in vehicle-treated rats (excretion of 52 ± 3% of the load) and from 3.0 ± 1.0 to 15.1 ± 1.8 μeq/min in losartan-treated rats (excretion of 65 ± 4% of the load, P < 0.05). When rats were changed from a low- to a high-sodium diet, cumulative sodium balance over 5 days was 7.8 ± 0.6 meq in vehicle-treated rats and 4.2 ± 0.4 meq in losartan-treated rats ( P < 0.05). In congestive heart failure, losartan treatment improved cardiac baroreflex regulation of renal sympathetic nerve activity, which was associated with improved ability to excrete acute and chronic sodium loads.

scholarly journals Impact of Melatonin and Branched-Chain Amino Acids Cosupplementation on Quality of Life, Fatigue, and Nutritional Status in Cachectic Heart Failure Patients: A Randomized Controlled Trial

2019 ◽  
pp. 155982761987404 ◽  
Author(s):  
Hamed Jafari-Vayghan ◽  
Jalal Moludi ◽  
Sevda Saleh-Ghadimi ◽  
Elgar Enamzadeh ◽  
Mir Hossein Seyed-Mohammadzad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Amino Acids ◽  
Placebo Group ◽  
Nutritional Status ◽  
Branched Chain Amino Acids ◽  
Significant Difference ◽  
Branched Chain ◽  
The Impact

Background: Cardiac cachexia (CC) adversely affects the lifestyle of heart failure (HF) patients. The current study examined the impact of melatonin cosupplementation and branched-chain amino acids (BCAAs) on quality of life (QoL), fatigue, and nutritional status in cachectic HF patients. Methods: In this trial, 84 CC patients were randomized to melatonin, BCAAs, or coadministration (both) as intervention groups and a control group over 8 weeks. At baseline and postintervention, QoL, fatigue, and nutritional status were assessed. Results: After intervention, improvement in the overall and physical dimensions of QoL and appetite score were found to be statistically significant in the BCAAs (P < .001) and the melatonin+BCAAs (P < .001) groups compared with the placebo group. The emotional dimension score was significantly lower in the BCAAs group compared with the placebo group (P = .001). There was a statistically significant improvement in fatigue severity in all 3 intervention groups compared with the placebo group. The nutrition risk index (NRI) score increased significantly only in the melatonin group (P = .015), and there was no significant difference between the other groups (P = .804). Conclusions: Cosupplementation with BCAAs and melatonin improved QoL, fatigue status, and appetite in cachectic HF patients but did not affect NRI.

scholarly journals Randomised Double-Blind Trial of Combination Antibiotic Therapy in Rheumatoid Arthritis

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Smith ◽  
Caroline Doré ◽  
Peter Charles ◽  
Alena Vallance ◽  
Tara Potier ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Placebo Group ◽  
Active Treatment ◽  
Active Rheumatoid Arthritis ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Good Evidence ◽  
Double Blind ◽  
Acr20 Response ◽  
Significant Difference

Objective. A combination of intravenous clindamycin and oral tetracycline has been used for many years as a treatment for active rheumatoid arthritis (RA), despite the absence of good evidence for its efficacy. A single-blind pilot study of this therapy suggested that a double-blind placebo-controlled trial was warranted.Methods. Patients with active RA were randomised in a 2 : 1 ratio to receive active treatment or placebo for 25 weeks. The active treatment consisted of intravenous clindamycin in a reducing regime, and oral tetracycline twice daily three times a week. 50 patients were to be recruited. The primary outcome measure was the proportion of patients achieving an ACR20 response.Results. An interim statistical analysis was performed after 20 patients had completed the study. Two patients in the active group achieved an ACR20 response, with none in the placebo group (NS). There was a better ESR20 response in the placebo group (P=.02). There were no other significant differences between the groups. The results indicated that it was unlikely that a significant difference in ACR20 response would emerge if the remaining 30 patients were recruited. The trial was therefore halted.Conclusion. This antibiotic regime is unlikely to be a valuable therapy for active rheumatoid arthritis.

scholarly journals The Effects of Propolis Extract Administration on HIV Patients Receiving ARV

2021 ◽  
Vol 13 (1) ◽  
pp. 75-83
Author(s):  
Erwin Astha Triyono ◽  
Sarah Firdausa ◽  
Heru Prasetyo ◽  
Joni Susanto ◽  
James Hutagalung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Placebo Group ◽  
Clinical Symptoms ◽  
Cd4 Count ◽  
Controlled Clinical Trial ◽  
Human Immune System ◽  
Hiv Patients ◽  
Double Blind ◽  
Significant Difference

BACKGROUND: Human immunodeficiency virus (HIV) is an infectious disease that targets the human immune system by attacking cluster of differentiation (CD)4 cells. The use of propolis in HIV patients is expected to be safe and beneficial in terms of increasing endurance and immunity by its role in increasing CD4 level. This study aimed to analyze the influence of propolis supplementation in increasing the CD4 level in anti-retroviral (ARV)-treated HIV patients.METHODS: Double-blind randomized controlled clinical trial was conducted in 50 HIV patients who took regular ARV therapy. The subjects were divided into two groups, one group was treated with ARV and propolis, while another one was given ARV and placebo. The CD4 cell count was measured during pre-treatment, in the 3rd month, in the 6th month after treatment. The level of hemoglobin, leukocyte, and platelets were also measured. The SF-12 questionnaire was used to evaluate quality of life of the subject.RESULTS: Out of 50 subjects, 43 subjects completed the study, which were 19 subjects from the propolis group and 24 subjects from the placebo group. After 3-month of treatment, there was a statistically significant difference in the incrwase of CD 44 level in propolis group, while the increment was not significant in the placebo group. After 6-month treatment, the increase of CD4 level was occurred in both groups, propolis and placebo, however the increment was not statistically significant. The levels of hemoglobin, leukocyte, and platelets were not altered by the treatment and remained normal throughout the study. The quality of life was improved during the study; however, it was also not statistically significant. Mild adverse events occurred in 3 subjects which were relieved after the treatment stopped.CONCLUSION: Based on the result of this study, the administration of propolis on HIV patients receiving ARV bring significant difference in the increase of CD4 in propolis group from baseline to 3 month after the treatment. While in placebo group, this increment was not significant. At the end of study, CD4 count continued to rise up, however the increase was not statistically significant. There are no hemoglobin, leukocyte, platelets, and quality of life abnormalities. Therefore, it is necesary to do further research with a spesific CD4 count. However, it may be beneficial in relieving the clinical symptoms and quality of life of patient living with HIV.KEYWORDS: CD4, ARV, HIV, propolis

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