Comparison of changes in respiratory function and exercise oxygen uptake with losartan versus enalapril in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

The American Journal of Cardiology
M GuazziP Agostoni

Abstract

In congestive heart failure (CHF), some of the effects of angiotensin-converting enzyme (ACE) inhibitors, such as an increase in exercise oxygen uptake (VO2), are mediated through prostaglandins. Angiotensin (AT1) receptor blockers apparently do not share potentiation of this biosystem. We tested whether losartan improves exercise VO2 in CHF and if the effect is the same as for enalapril. Sixteen men with CHF and 8 volunteers, all nonsmokers and not taking ACE, AT1 receptor, or cyclooxygenase inhibitors, were randomized to receive placebo, enalapril (10 mg 2 times daily), losartan (50 mg/day), each of these 2 drugs plus aspirin (325 mg/day), aspirin, or the same preparations in a reverse order, each for 3 weeks, with a 3-week washout period between treatments. Pulmonary function and VO2 were assessed at the end of each treatment. In CHF, losartan and enalapril caused a similar improvement of VO2 and exercise tolerance, which was absent in controls and was counteracted by aspirin (prostaglandin inhibition) when obtained with enalapril and not with losartan. While on enalapril, we also detected an increase in the diffusing lung capacity for carbon monoxide, which correlated with changes in VO2 and was antagonized by aspirin, sugg...Continue Reading

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Citations

Jul 17, 2008·Vascular Health and Risk Management·Roberto Negro
Oct 18, 2008·Journal of Cardiac Failure·Marco Guazzi
Jul 21, 2009·The Journal of Clinical Hypertension·Maria Leonarda De Rosa, Massimo Chiariello
Jul 30, 1999·American Heart Journal·J R Teerlink, B M Massie
May 2, 2001·The American Journal of Medicine·R TabibiazarS G Rockson
Apr 8, 1999·Journal of the American College of Cardiology·H P Brunner-La RoccaM D Esler
Dec 19, 2006·Journal of the American College of Cardiology·Emil M deGomaEuan A Ashley
Jan 17, 2002·The Annals of Pharmacotherapy·K L Olson
Jul 29, 2006·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·UNKNOWN Task Force of the Italian Working Group on Cardiac Rehabilitation and Prevention (Gruppo Italiano di Cardiologia Riabilitati, UNKNOWN Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology
Jan 11, 2011·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Massimo F PiepoliUNKNOWN Working Group ‘Exercise Physiology, Sport Cardiology and Cardiac Rehabilitation’, Italian Society of Cardiology
Apr 5, 2017·Annals of the American Thoracic Society·Mauro Contini
Apr 15, 2003·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Bo-qing ZhuWilliam W Parmley
May 12, 2001·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·I MahéJ F Bergmann
May 23, 2002·The Annals of Pharmacotherapy·Kathleen A PackardAmy J Arouni
May 8, 2021·Respiratory Physiology & Neurobiology·Alessandra MaginiPiergiuseppe Agostoni

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