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Clinical and hemodynamic effects of renin-angiotensin system blockade in cardiac transplant recipients.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2011 Dec 15; Vol. 108 (12), pp. 1836-9. - Publication Year :
- 2011
-
Abstract
- Chronic kidney disease continues to be a major limiting factor for long-term survival of heart transplant recipients. Little is known about the early use of renin-angiotensin system (RAS) blocking agents and their impact on renal function and hemodynamics in heart transplant recipients. In this cohort study all eligible recipients of orthotopic heart transplants at the UTAH cardiac transplantation program from 2001 through 2007 were divided into 2 groups-patients who were started on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers within the first 4 weeks of transplantation and continued on these for ≥4 weeks during the first 3 months (RAS blockade group, n = 75) and those who were not (non-RAS blockade group, n = 52). All patients were followed for 1 year after transplantation. There were no significant differences at baseline between the 2 groups. Estimated glomerular filtration rate at 12 months was significantly higher in the RAS blockade group compared to the non-RAS blockade group (mean ± SD, 56.3 ± 22.4 vs 47.3 ± 18.1 ml/min/1.73 m(2), p = 0.036). At 12 months pulmonary artery systolic pressure was significantly lower in the RAS blockade group compared to the non-RAS blockade group (30.2 ± 7.4 vs 32.9 ± 9.3 mm Hg, p = 0.023). Left ventricular ejection fraction and pulmonary capillary wedge pressure were similar between the 2 groups. In conclusion, early RAS blockade after heart transplantation is safe, well tolerated, and associated with better renal function and hemodynamic profile at 1 year after transplantation.<br /> (Published by Elsevier Inc.)
- Subjects :
- Female
Humans
Male
Middle Aged
Angiotensin Receptor Antagonists pharmacology
Angiotensin Receptor Antagonists therapeutic use
Angiotensin-Converting Enzyme Inhibitors pharmacology
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Glomerular Filtration Rate drug effects
Heart Transplantation
Hemodynamics drug effects
Kidney drug effects
Kidney physiology
Renin-Angiotensin System drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 108
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 22133132
- Full Text :
- https://doi.org/10.1016/j.amjcard.2011.07.059