The acute effect of ACEI and ARB's upon endothelin in heart failure patients.
OBJECTIVE
to compare the acute effect of ACEI and ARB's upon the plasmatic endothelin level in heart failure patients.


METHODS
There were studied 30 patients with congestive heart failure, III-IV functional NYHA class, that were not under ACEI or ARB's treatment. In all the patients the endothelinl-21 plasmatic level was determined. After this, 20 patients, representing group I, received a single dose of 1 mg trandolapril, and 10 patients, representing group II, received a single dose of 40 mg telmisartan. After 24 hours, the plasmatic endothelin 1-21 level was determined again.


RESULTS
The mean endothelial plasmatic level was similar in both groups (group I: 0.358+/-0.04 fmol/ml; group II: 0.345+/-0.038). After 24 hours, the endothelin level decreased to 0.295+/-0.03 fmol/ml for group I (p<0.05) and to 0.287+/-0.029 fmol/ml for group II (p<0.05), suggesting that both ACEI and ARB's are equally efficient in decreasing endothelin. The initial endothelinl-21 level was inversely correlated with LVEF (r = -0.989), and the degree of the decrease of endothelinl-21 after both ACEI and ARB's is directly correlated with the initial endothelinl-21 level (r =0.64).


CONCLUSIONS
The acute administration of ACEI and ARB's in heart failure patients decreases the endothelin level, both categories of drugs having the same effects.
Zdrenghea
D
D
Cardiology Department, Rehabilitation Clinical Hospital, Cluj-Napoca, Romania. dzdrenghea@hotmail.com
Pop
Dana
D
Bodizs
G
G
Cebanu
Mirela
M
Rusu
Ramona
R
Grosz
C S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D001562:Benzimidazoles / Q000494:pharmacology*; D001565:Benzoates / Q000494:pharmacology*; D019332:Endothelin-1 / Q000097:blood; D016232:Endothelins / Q000097:blood*; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D007211:Indoles / Q000494:pharmacology*; D008875:Middle Aged; D000077333:Telmisartan
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D019332:Endothelin-1; D016232:Endothelins; D007211:Indoles; C052035:trandolapril; D000077333:Telmisartan