[Heart failure and vasopeptidase inhibitors].
The morbidity and mortality of cardiac insufficiency remains such that it justifies the pursuit of finding new drugs and new sensitive techniques to slow or abolish its evolution. Bringing the vasopeptidases, such as omapatrilat, up to date results in a rational process aimed at simultaneously modulating certain interactive humoral systems. They represent drugs which simultaneously inhibit neutral endopeptidase and angiotensin converting enzyme with the effect of potentiating the natiuretic peptide system and bradykinin, and blocking the conversion of angiotensin I and angiotensin II. In the IMPRESS study, omapatrilat has been evaluated in patients with cardiac insufficiency versus lisinopril; there was no significant difference on the principal outcome measure which was exercise tolerance, however it was significantly more effective than lisinopril on the outcome measure combining death and hospital admission for deteriorating cardiac insufficiency. A wider study is underway, the OVERTURE study, which is evaluating omapatrilat versus enalapril on hospital admission and all-cause mortality. The Vanlev dossier has not yet been submitted to the regulatory authorities for obtaining its authorisation to be put on the market.
Bareiss
P
P
Service de cardiologie, hôpital de Hautepierre, avenue Molière, hôpitaux universitaires de Strasbourg, 67098 Strasbourg.
Ohlmann
P
P
Roul
G
G
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D001920:Bradykinin / Q000494:pharmacology; D002303:Cardiac Output, Low / Q000188:drug therapy*; D006801:Humans; D017706:Lisinopril / Q000494:pharmacology / Q000627:therapeutic use*; D045283:Natriuretic Agents / Q000494:pharmacology; D010447:Peptide Hydrolases / Q000494:pharmacology; D011480:Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013841:Thiazepines / Q000494:pharmacology / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D045283:Natriuretic Agents; D011480:Protease Inhibitors; D011725:Pyridines; D013841:Thiazepines; C106266:omapatrilat; D017706:Lisinopril; D010447:Peptide Hydrolases; D001920:Bradykinin
Insuffisance cardiaque et inhibiteurs des vasopeptidases.