Effect of losartan on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation

Seküri, Cevad; Ütük, Ozan; Bayturan, Özgür; Bilge, Ali; Kurhan, Ziya; Tavlı, Talat

doi:10.3317/jraas.2008.016

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Sekuri et al . 23 found that losartan can improve the exercise tolerance and echocardiographic parameters in patients with rheumatic mitral regurgitation (MR) disease. Compared with rheumatic mitral valve disease, rheumatic aortic or tricuspid valve diseases are rare.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Chockalingam et al 22 found that enalapril not only was well tolerated but also improved functional status and exercise capacity in RHD patients with moderate and severe mitral stenosis (MS), especially in patients with concomitant regurgitant valvular heart disease. Sekuri et al 23 found that losartan can improve the exercise tolerance and echocardiographic parameters in patients with rheumatic mitral regurgitation (MR) disease. Compared with rheumatic mitral valve disease, rheumatic aortic or tricuspid valve diseases are rare.…”

Section: Effect Of Renin-angiotensin-aldosterone System Inhibitor Tre...mentioning

confidence: 99%

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Impact of renin‐angiotensin system inhibitors on long‐term clinical outcomes of patients with rheumatic heart disease

Liu

Lai

et al. 2021

ESC Heart Failure

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Aims Rheumatic heart disease (RHD) remains a major global health problem. Renin-angiotensin-aldosterone system inhibitors (RAASi) are commonly administered in the treatment of cardiovascular disease, but its role in RHD patients is still limited. We performed a retrospective study to determine the effect of RAASi on long-term outcomes for RHD patients. Methods and results A 1:1 propensity score matching was implemented to balance baseline characteristics between groups RAASi and non-RAASi. Cox proportional hazards regression model was used to investigate the associations of RAASi with the risks of all-cause mortality, cardiovascular death (CVD), and cerebrovascular death. Binary logistic regression analysis was used to evaluate the associations of RAASi with the risks of 1, 3, and 5 year heart failure (HF) rehospitalization, new-onset atrial fibrillation (AF), and new-onset stroke. A total of 734 RHD patients were enrolled as study participants; nearly half of these participants had combined valve damage (54.4%), worse New York Heart Association functional class status (III and IV, 55.2%), surgical treatment (54.2%), and AF (65.0%). After propensity score matching, 514 RHD patients were finally analysed. RAASi treatment was associated with decreased risks of all-cause mortality [adjusted hazard ratio (HR) = 0.52, 95% confidence interval (CI): 0.37-0.73, P < 0.001], CVD (adjusted HR = 0.48, 95% CI: 0.30-0.76, P = 0.002), and cerebrovascular death (adjusted HR = 0.22, 95% CI: 0.08-0.60, P = 0.003). Further subgroup analysis showed that RAASi treatment was associated with decreased risks of all-cause mortality (adjusted HR = 0.50, 95% CI: 0.31-0.79, P = 0.004), CVD (adjusted HR = 0.48, 95% CI: 0.25-0.91, P = 0.025), and cerebrovascular death (adjusted HR = 0.19, 95% CI: 0.05-0.65, P = 0.008) in RHD patients without surgical treatment, and better effect was observed in RHD patients with surgical treatment on the risks of all-cause mortality (adjusted HR = 0.47, 95% CI: 0.26-0.85, P = 0.012) and CVD (adjusted HR = 0.43, 95% CI: 0.21-0.90, P = 0.024) except cerebrovascular death (adjusted HR = 0.52, 95% CI: 0.08-3.36, P = 0.491). RAASi treatment was associated with decreased HF rehospitalization risk of 1 year [adjusted odds ratio (OR) = 0.38, 95% CI: 0.23-0.61, P < 0.001], 3 year (adjusted OR = 0.43, 95% CI: 0.28-0.68, P < 0.001), and 5 year (adjusted OR = 0.48, 95% CI: 0.30-0.77, P = 0.002) as well as new-onset AF risk (adjusted OR = 0.38, 95% CI: 0.21-0.68, P = 0.001). RAASi treatment had nothing to do with new-onset stroke risk (adjusted OR = 0.80, 95% CI: 0.47-1.38, P = 0.428). Conclusion Renin-angiotensin-aldosterone system inhibitor treatment was significantly associated with decreased risks of mortality, HF rehospitalization, and new-onset AF in RHD patients in median 5.9 year follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Effect Of Renin-angiotensin-aldosterone System Inhibitor Tre...mentioning

confidence: 99%

Impact of renin‐angiotensin system inhibitors on long‐term clinical outcomes of patients with rheumatic heart disease

Liu

Lai

et al. 2021

ESC Heart Failure

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“…Specifically, the regurgitant volume and the effective regurgitant orifice decreased and the effect was durable for 1 month [15]. Another trial assessing moderate degenerative and rheumatic MR also found a beneficial effect with losartan over a 6-week period with regards to MR severity, LA size, and LV function [23].…”

Section: Vasodilators In Chronic Mitral Regurgitationmentioning

confidence: 92%

Role of Medical Therapy in Chronic Mitral Regurgitation

Meel¹

2020

The Current Perspectives on Coronary Artery Bypass Grafting

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Mitral regurgitation is one of the most commonly encountered valvular heart diseases in both the developing and the developed world. From various studies, it is known that chronic mitral regurgitation is associated with progressive left ventricular dysfunction, and eventually death if left untreated. This disease has a long silent period before symptoms manifest. During this latent period, left ventricular function progressively deteriorates and results in poor outcomes for patients even if surgery is performed. A few studies have evaluated the role of medical therapy in patients with chronic mitral regurgitation. This chapter will provide an overview of the use of medical therapy in chronic mitral regurgitation.

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“…13 Diuretic therapy is indicated for management of volume and symptoms but has not been found to result in survival benefit. 14 By the reduction of left ventricular afterload, angiotensin-converting enzyme inhibition improves exercise tolerance and echocardiographic indices in severe mitral regurgitation, and is particularly beneficial in the setting of concomitant systemic hypertension, 15 but it has yet to be found to confer a definite survival benefit. The patient's CHA 2 DS 2 -VASc score is 5, with points assigned for heart failure, hypertension, age, and sex.…”

Section: Which One Of Thementioning

confidence: 99%

95-Year-Old Woman With Sudden-Onset Dyspnea

Abudiab

Odunukan

Freeman

2012

Mayo Clinic Proceedings

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A 95-year-old woman presented with sudden-onset dyspnea of 4 hours' duration, which was soon followed by respiratory failure requiring high-flow supplemental oxygen. She denied having chest pain, back pain, or palpitations. She had completed a course of amoxicillin 2 months previously for acute sinusitis and had no residual symptoms. Results of a complete review of systems were otherwise unremarkable.Her medical history was notable for systemic hypertension, pulmonary hypertension, chronic severe mitral regurgitation related to degenerative mitral valve disease with prolapse, and moderate functional tricuspid regurgitation. She had no personal history of coronary artery disease or congestive heart failure. Medications included amlodipine, atenolol, chlorthalidone, fluticasone, and dicyclomine.On arrival at the emergency department her vital signs were as follows: blood pressure, 194/110 mm Hg; pulse, 137 beats/min; temperature, 36.5°C; respiratory rate, 36 breaths/min; and oxygen saturation while receiving 15 L of oxygen per minute by closed face mask, 91%. She had markedly increased work of breathing. Cardiovascular examination demonstrated jugular venous distention to the ear with a prominent v wave, irregularly irregular tachycardia, right ventricular lift without thrill, an S 3 gallop at the apex, a blowing holosystolic murmur appreciated throughout the precordium, and 2 mm of pitting edema of the mid shins bilaterally. Pulmonary examination revealed coarse crackles throughout the basilar half of both lung fields. Abdominal, musculoskeletal, neurologic, and integument findings were unremarkable. Chest radiography demonstrated the new findings of pulmonary venous congestion and bilateral effusions.

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Effect of losartan on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation

Cited by 6 publications

References 20 publications

Impact of renin‐angiotensin system inhibitors on long‐term clinical outcomes of patients with rheumatic heart disease

Impact of renin‐angiotensin system inhibitors on long‐term clinical outcomes of patients with rheumatic heart disease

Role of Medical Therapy in Chronic Mitral Regurgitation

95-Year-Old Woman With Sudden-Onset Dyspnea

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