title: Effects of angiotensin II type 1 receptor antagonist, losartan, on ventilatory response to exercise and neurohormonal profiles in patients with chronic heart failure.
abstract: Chronic heart failure (CHF) is associated with abnormal neurohormonal profiles and increased ventilatory response to exercise. This study determined if treatment with angiotensin II type 1 receptor antagonist, losartan, improves ventilatory efficiency and neurohormonal factors in patients with CHF. Symptom-limited cardiopulmonary exercise testing was performed after a 2-week placebo period (baseline) and after 16 weeks of treatment with losartan (40 +/- 4 mg/day) in 10 patients with CHF (age 57.7 +/- 3.7 years). Echocardiogram, daily physical activity (by the specific activity scale), and neurohormones were evaluated. Treatment with losartan increased left ventricular ejection fraction (baseline vs. losartan: 31 +/- 3 vs. 39 +/- 3%, p<0.01) and specific activity scale score (5.3 +/- 0.5 vs. 6.4 +/- 0.4 METS, p<0.05). Losartan decreased the ventilatory response to carbon dioxide production during exercise (VE/VCO2 slope: 34.6 +/- 2.4 vs. 32.0 +/- 2.2, p<0.05). Plasma brain natriuretic peptide concentrations were decreased after therapy (301 +/- 79 vs. 176 +/- 53 pg/ml, p<0.05). In summary, the results of this open-label, uncontrolled study suggest that chronic treatment with losartan may improve ventilatory efficiency and decrease plasma brain natriuretic peptide concentrations with the improvement of physical activity and left ventricular systolic function in patients with CHF.
authors.affiliation: Department of Cariovascular Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504 Japan. kinugawa@grape.med.tottori-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Kinugawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ogino
authors.forename: Shuichi
authors.initials: S
authors.lastname: Osaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Igawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hisatome
authors.forename: Chiaki
authors.initials: C
authors.lastname: Shigemasa
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D006985:Hyperventilation / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood*; D012123:Pulmonary Ventilation / Q000187:drug effects*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D018377:Neurotransmitter Agents; D019808:Losartan