OBJECTIVE: To compare the effects of the angiotensin II receptor antagonist candesartan with the angiotensin-converting enzyme inhibitor enalapril on myocardial fibrosis evaluated by echoreflectivity analysis. METHODS: Hypertensive patients (n = 196) with echocardigraphically documented left ventricular hypertrophy were randomized to candesartan 8-16 mg/day (n = 91) or enalapril 10-20 mg/day (n = 105) with possible addition of hydrochlorothiazide (12.5-25 mg/day) for 48 weeks. Echoreflectivity analysis was performed on ultrasound two-dimensional tracings of the midapex septum with a specifically designed and validated software. Colour histograms were obtained; the primary outcome variable was the treatment-related change in histogram width (broadband), previously shown to correlate with collagen volume on endomyocardial biopsy; changes in mean colour scale were secondary outcome variable. RESULTS: Echoreflectivity analysis was feasible in 84 patients (48 candesartan, 36 enalapril). Broadband decreased significantly in the candesartan (-8.0 colour levels) and in the enalapril group (-12.9 colour levels) with no significant difference between treatments (P = 0.409); no significant changes occurred in mean colour scale. Patients under monotherapy (n = 46) showed similar trends as the larger intention to treat cohort, without significant difference between treatments. CONCLUSION: In hypertensive patients with left ventricular hypertrophy, both candesartan and enalapril induce a moderate but statistically significant reduction in an echoreflectivity index of myocardial fibrosis.

Ciulla, M., Paliotti, R., Esposito, A., Cuspidi, C., Muiesan, M., Rosei, E., et al. (2009). Effects of anthiipertensives treatment on ultrasound measures of myocardial fibrosis in hipertensives patientes with left ventriculare hypertrophy:results of a randomized trial comparing the angiotensin receptor antagonist, candesartan and the angiotensin-converting enzyme inhibitor, enalapril. JOURNAL OF HYPERTENSION, 27(3), 626-632 [10.1097/HJH.0b013e3283232838].

Effects of anthiipertensives treatment on ultrasound measures of myocardial fibrosis in hipertensives patientes with left ventriculare hypertrophy:results of a randomized trial comparing the angiotensin receptor antagonist, candesartan and the angiotensin-converting enzyme inhibitor, enalapril

CUSPIDI, CESARE;
2009-03

Abstract

OBJECTIVE: To compare the effects of the angiotensin II receptor antagonist candesartan with the angiotensin-converting enzyme inhibitor enalapril on myocardial fibrosis evaluated by echoreflectivity analysis. METHODS: Hypertensive patients (n = 196) with echocardigraphically documented left ventricular hypertrophy were randomized to candesartan 8-16 mg/day (n = 91) or enalapril 10-20 mg/day (n = 105) with possible addition of hydrochlorothiazide (12.5-25 mg/day) for 48 weeks. Echoreflectivity analysis was performed on ultrasound two-dimensional tracings of the midapex septum with a specifically designed and validated software. Colour histograms were obtained; the primary outcome variable was the treatment-related change in histogram width (broadband), previously shown to correlate with collagen volume on endomyocardial biopsy; changes in mean colour scale were secondary outcome variable. RESULTS: Echoreflectivity analysis was feasible in 84 patients (48 candesartan, 36 enalapril). Broadband decreased significantly in the candesartan (-8.0 colour levels) and in the enalapril group (-12.9 colour levels) with no significant difference between treatments (P = 0.409); no significant changes occurred in mean colour scale. Patients under monotherapy (n = 46) showed similar trends as the larger intention to treat cohort, without significant difference between treatments. CONCLUSION: In hypertensive patients with left ventricular hypertrophy, both candesartan and enalapril induce a moderate but statistically significant reduction in an echoreflectivity index of myocardial fibrosis.
Articolo in rivista - Articolo scientifico
Scientifica
Angiotensin receptor blocker; Angiotensin-converting enzyme inhibitor; Echoreflectivity; Hypertrophy; Myocardial fibrosis;
English
Ciulla, M., Paliotti, R., Esposito, A., Cuspidi, C., Muiesan, M., Rosei, E., et al. (2009). Effects of anthiipertensives treatment on ultrasound measures of myocardial fibrosis in hipertensives patientes with left ventriculare hypertrophy:results of a randomized trial comparing the angiotensin receptor antagonist, candesartan and the angiotensin-converting enzyme inhibitor, enalapril. JOURNAL OF HYPERTENSION, 27(3), 626-632 [10.1097/HJH.0b013e3283232838].
Ciulla, M; Paliotti, R; Esposito, A; Cuspidi, C; Muiesan, M; Rosei, E; Magrini, F; Zanchetti, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/388871
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