Effects of Quinapril on left atrial structural remodeling and arterial stiffness

Teresa S M Tsang, Marion E. Barnes, Walter P. Abhayaratna, Steven S. Cha, Bernard J. Gersh, Andrew P. Langins, Tammy D. Green, Kent R Bailey, Yoko Miyasaka, James B. Seward

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Left atrial (LA) enlargement, left ventricular (LV) diastolic dysfunction, and increased arterial stiffness are all associated with adverse cardiovascular outcomes. The rate, magnitude, and concordance of modifiability of these risk markers have not been well characterized. Twenty-one patients (mean age 69 ± 8 years; 52% women) with isolated diastolic dysfunction and indexed LA volumes <32 ml/m2 were randomly assigned to receive either quinapril at a target dose of 60 mg/day or matching placebo for 12 months. Echocardiographic maximum LA volume and LV diastolic function and arterial stiffness by the augmentation index were measured at baseline and 6 and 12 months. Analysis was based on intention to treat. Baseline characteristics were comparable between the treatment (n = 9) and placebo (n = 12) groups. The mean reduction in LA volume of 4.2 ± 7.8 ml/m2 in the quinapril group was significant (p = 0.01) compared with the increase in LA volume in the placebo group (5.5 ± 8.1 ml/m2). This represents a relative improvement of 9.7 ml/m2. Change in LV filling pressure in terms of E/e′ and diastolic function grade did not reach significance. A reduction in the augmentation index was associated with a decrease in indexed LA volume (odds ratio 11, p = 0.046), independent of changes in systolic blood pressure. In conclusion, LA structural remodeling appeared reversible with quinapril, which occurred in parallel with an improvement in arterial stiffness but independent of blood pressure changes.

Original languageEnglish (US)
Pages (from-to)916-920
Number of pages5
JournalAmerican Journal of Cardiology
Volume97
Issue number6
DOIs
StatePublished - Mar 15 2006

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Atrial Remodeling
Vascular Stiffness
Placebos
Blood Pressure
Left Ventricular Dysfunction
Ventricular Pressure
Left Ventricular Function
Odds Ratio
quinapril
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Tsang, T. S. M., Barnes, M. E., Abhayaratna, W. P., Cha, S. S., Gersh, B. J., Langins, A. P., ... Seward, J. B. (2006). Effects of Quinapril on left atrial structural remodeling and arterial stiffness. American Journal of Cardiology, 97(6), 916-920. https://doi.org/10.1016/j.amjcard.2005.09.143

Effects of Quinapril on left atrial structural remodeling and arterial stiffness. / Tsang, Teresa S M; Barnes, Marion E.; Abhayaratna, Walter P.; Cha, Steven S.; Gersh, Bernard J.; Langins, Andrew P.; Green, Tammy D.; Bailey, Kent R; Miyasaka, Yoko; Seward, James B.

In: American Journal of Cardiology, Vol. 97, No. 6, 15.03.2006, p. 916-920.

Research output: Contribution to journalArticle

Tsang, TSM, Barnes, ME, Abhayaratna, WP, Cha, SS, Gersh, BJ, Langins, AP, Green, TD, Bailey, KR, Miyasaka, Y & Seward, JB 2006, 'Effects of Quinapril on left atrial structural remodeling and arterial stiffness', American Journal of Cardiology, vol. 97, no. 6, pp. 916-920. https://doi.org/10.1016/j.amjcard.2005.09.143
Tsang TSM, Barnes ME, Abhayaratna WP, Cha SS, Gersh BJ, Langins AP et al. Effects of Quinapril on left atrial structural remodeling and arterial stiffness. American Journal of Cardiology. 2006 Mar 15;97(6):916-920. https://doi.org/10.1016/j.amjcard.2005.09.143
Tsang, Teresa S M ; Barnes, Marion E. ; Abhayaratna, Walter P. ; Cha, Steven S. ; Gersh, Bernard J. ; Langins, Andrew P. ; Green, Tammy D. ; Bailey, Kent R ; Miyasaka, Yoko ; Seward, James B. / Effects of Quinapril on left atrial structural remodeling and arterial stiffness. In: American Journal of Cardiology. 2006 ; Vol. 97, No. 6. pp. 916-920.
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