TY - JOUR
T1 - Effect of losartan on degree of mitral regurgitation quantified by echocardiography
AU - Dujardin, Karl S.
AU - Enriquez-Sarano, Maurice
AU - Bailey, Kent R.
AU - Seward, James B.
AU - Tajik, A. Jamil
N1 - Funding Information:
This study was supported by the Mayo General Clinical Research Center (Grant RR00585), Rochester, Minnesota; and by a fellowship to Dr. Dujardin from the Belgian American Educational Foundation.
Funding Information:
The study was approved by the institutional review board and was conducted in our general clinical research center, funded by the National Institutes of Health, without industry support.
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 2001/3/1
Y1 - 2001/3/1
N2 - The objective of this study was to determine the effect of oral losartan on the degree of mitral regurgitation (MR). The regurgitant volume and effective regurgitant orifice were quantified using 3 methods (flow convergence, quantitative Doppler, and quantitative 2-dimensional echocardiography) in 32 patients (26 men, mean age 67 ± 14 years) with MR, both at baseline and 4 hours after losartan (50 mg orally). Twenty-eight patients were also reevaluated after 1 month of continued treatment with losartan (50 mg/day). With treatment, systolic blood pressure decreased from 143 ± 16 to 130 ± 18 mm Hg and left ventricular end-systolic wall stress from 173 ± 46 to 156 ± 44 g/cm2 (both p <0.001). With treatment, regurgitant volume decreased (from 77 ± 28 to 64 ± 26 ml, -18 ± 10%; p <0.001) in direct relation to the effective regurgitant orifice change (from 43 ± 16 to 37 ± 15 mm2, -17 ± 10%; p <0.001) but without significant change in regurgitant gradient or duration. Wide individual variability in response was observed unrelated to the magnitude of blood pressure changes. Larger reduction in regurgitant volume was observed in patients with a marked decrease in wall stress (r = 0.47, p = 0.01) and higher baseline end-diastolic volume index (r = -0.38, p = 0.03) and regurgitant volume (r = -0.45, p = 0.01). Acute improvements were sustained and unchanged at 1 month (all p >0.15). Treatment of MR using the angiotensin receptor antagonist losartan produces a significant and sustained decrease in the degree of MR, with decreases in regurgitant volume and effective regurgitant orifice. However, the changes are of modest and variable magnitude.
AB - The objective of this study was to determine the effect of oral losartan on the degree of mitral regurgitation (MR). The regurgitant volume and effective regurgitant orifice were quantified using 3 methods (flow convergence, quantitative Doppler, and quantitative 2-dimensional echocardiography) in 32 patients (26 men, mean age 67 ± 14 years) with MR, both at baseline and 4 hours after losartan (50 mg orally). Twenty-eight patients were also reevaluated after 1 month of continued treatment with losartan (50 mg/day). With treatment, systolic blood pressure decreased from 143 ± 16 to 130 ± 18 mm Hg and left ventricular end-systolic wall stress from 173 ± 46 to 156 ± 44 g/cm2 (both p <0.001). With treatment, regurgitant volume decreased (from 77 ± 28 to 64 ± 26 ml, -18 ± 10%; p <0.001) in direct relation to the effective regurgitant orifice change (from 43 ± 16 to 37 ± 15 mm2, -17 ± 10%; p <0.001) but without significant change in regurgitant gradient or duration. Wide individual variability in response was observed unrelated to the magnitude of blood pressure changes. Larger reduction in regurgitant volume was observed in patients with a marked decrease in wall stress (r = 0.47, p = 0.01) and higher baseline end-diastolic volume index (r = -0.38, p = 0.03) and regurgitant volume (r = -0.45, p = 0.01). Acute improvements were sustained and unchanged at 1 month (all p >0.15). Treatment of MR using the angiotensin receptor antagonist losartan produces a significant and sustained decrease in the degree of MR, with decreases in regurgitant volume and effective regurgitant orifice. However, the changes are of modest and variable magnitude.
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U2 - 10.1016/S0002-9149(00)01433-8
DO - 10.1016/S0002-9149(00)01433-8
M3 - Article
C2 - 11230841
AN - SCOPUS:0035282995
SN - 0002-9149
VL - 87
SP - 570
EP - 576
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 5
ER -