July 1, 2012Open Access

The Renin‐Angiotensin System and Right Ventricular Structure and Function: The MESA‐Right Ventricle Study

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Right ventricular structure and function. Intervention: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (AIABs) vs. No AIAB use. Primary outcome: Right ventricular mass in African Americans (Difference -0.7 g, 95% CI -1.3 to -0.1, p=0.03).

Key Result

AIAB use was associated with lower RV mass in African Americans (-0.7 g, 95% CI -1.3 to -0.1, P=0.03) and larger RV end-diastolic volume in Caucasians (3.7 mL, 95% CI 0.7-6.8, P=0.02).

Study Design

Type

Cross-Sectional

PICO

Population

Right ventricular structure and function

Intervention / Comparator

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (AIABs) vs No AIAB use

Primary Outcome

Right ventricular mass in African Americans — Difference -0.7 g (-1.3 to -0.1), p=0.03

Main Result

Effect estimate: Difference -0.7 g (95% CI -1.3 to -0.1)

p-value: p=0.03

Abstract

The pulmonary vasculature is an important site of renin-angiotensin metabolism. While angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (collectively AIABs) have a role in left ventricular (LV) disease, the impact of AIABs on right ventricular (RV) function is unknown. AIAB use was determined by medication inventory during the Multi-Ethnic Study of Atherosclerosis baseline examination. RV measures were obtained via cardiac magnetic resonance imaging. The relationship between AIAB use and RV measures was assessed using multivariable linear regression, stratified by race/ethnicity, and adjusted for multiple covariates. AIAB use was associated with lower RV mass (-0.7 g, 95% confidence interval CI -1.3 to -0.1, P=0.03) in African Americans (N=1012) after adjustment for multiple covariates including LV mass. Among Caucasians (N=1591), AIAB use was associated with larger RV end-diastolic volume (3.7 mL, 95% CI 0.7-6.8, P=0.02) after adjustment for LV volume. No significant associations were seen between AIAB use and other RV measures or in Hispanic or Chinese American participants. AIAB use was associated with RV morphology in a race-specific and LV-independent manner, suggesting the renin-angiotensin system may play a unique role in RV structure and function. The use of AIABs in those with RV dysfunction warrants further study.

Read Full Paperexternally

Bookmark

View Full Paper

Cite This Study

Ventetuolo et al. (Sun,) conducted a cross-sectional in Right ventricular structure and function. Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (AIABs) vs. No AIAB use was evaluated on Right ventricular mass in African Americans (Difference -0.7 g, 95% CI -1.3 to -0.1, p=0.03). AIAB use was associated with lower RV mass in African Americans (-0.7 g, 95% CI -1.3 to -0.1, P=0.03) and larger RV end-diastolic volume in Caucasians (3.7 mL, 95% CI 0.7-6.8, P=0.02).

synapsesocial.com/papers/6a1c66b266d062ff2dc3c3c0 https://doi.org/https://doi.org/10.4103/2045-8932.101657

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Bookmark

View Full Paper