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ȣ - 480468 67 |
| Short-term Effects of Cilazapril on Vascular Response in Heart Failure |
| Division of Cardiology, Internal medicine, Dongsan Medical Center, Keimyung University |
| Min-Jung Kim, Kee-Sik Kim, Young-Soo Lee, Chang-Wook Park, Yun-Kyeong Cho, Chang-Wook Nam, Sang-Hoon Lee Seong-Wook Han, Seung-Ho Hur, Yoon-Nyun Kim, Kwon-Bae Kim |
Background: Increased oxidative stress in heart failure is thought to contribute to endothelial dysfunction. Angiotensin-converting enzyme (ACE) inhibitor therapy has been shown to improve on endothelial vasomotor dysfunction in heart failure and retard the progression of human atherosclerosis. We evaluated the short-term effects of the ACE inhibitor, Cilazapril, on endothelial dysfunction of the brachial artery and carotid atherosclerosis in patients with heart failure (HF). Methods: We randomized, prospectively studied 33 patients(mean age: 65.12±8.2 yrs, M:F=9:24), and classified two groups according to medication of Cilazapril ( 17 in Cilazapril and 16 in placebo). We measured the flow-mediated vasodilatation (FMD) of the brachial artery and intima-media thickness (IMT) of the carotid artery at base and 4-week follow up in HF patients (NYHA II-III). We calculated the mean difference between two groups. Results: All results are in the table. Conclusion: Cilazapril improved the endothelial dysfunction at short-term follow up. However, there were no differences on the atherosclerotic vascular changes to the IMT of carotid arteries.
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Cilazapril
(17) |
Placebo(16) |
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Cilazapril(17) |
Placebo(16) |
|
Age(yrs) |
61.4±6.4* |
69.0±8.2* |
Base
FMD (%) |
8.08±3.98 |
8.28±3.47 |
|
Male/Female |
7/10 |
2/14 |
Base
Rt-IMT-max (mm) |
0.92±0.13 |
1.01±0.15 |
|
BMI
(kg/m2) |
24.7±2.7 |
25.7±3.5 |
Base
Rt-IMT-mean(mm) |
0.75±0.10 |
0.83±0.13 |
|
Hypertension |
3
(17.6%) |
6
(37.5%) |
Base
Lt-IMT-max(mm) |
0.95±0.10 |
0.94±0.13 |
|
Smoker(%) |
2
(11.8%) |
1
(6.3 %) |
Base
Lt-IMT-mean(mm) |
0.74±0.11 |
0.78±0.12 |
|
Diabetse(%) |
1
(5.9%) |
1
(6.3%) |
Δ
FMD (%) |
2.59±4.43* |
0.31±2.90* |
|
Homo.(umol/L) |
12.11±3.02 |
14.08±4.91 |
Δ
Rt-IMT-max (mm) |
0.009±0.13 |
0.01±0.14 |
|
Pro-BNP
(pg/mL) |
447.7±1069.3 |
665.7±772.8 |
Δ
Rt-IMT-mean(mm) |
-0.02±0.11 |
-0.01±0.08 |
|
LDL-chol(mg/dL) |
152.5±42.7 |
137.6±54.5 |
Δ
Lt-IMT-max(mm) |
0.03±0.16 |
0.03±0.10 |
|
EF
(%) |
63.1±11.8 |
60.6±11.7 |
Δ
Lt-IMT-mean(mm) |
0.05±0.13 |
0.01±0.09 |
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*:<0.05,
BMI:body mass index, Homo.:homoncysteine, EF:ejection fraction, Δ:measure
at 4-week follow up minus base
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