What does this research mean for the field?

Combined ACE inhibition and AT1 receptor blockade reverses defects in myocyte excitation-contraction coupling and improves contractile function in congestive heart failure more effectively than either treatment alone. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 7, 1997Circulation

Modulation of the Renin-Angiotensin Pathway Through Enzyme Inhibition and Specific Receptor Blockade in Pacing-Induced Heart Failure

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Why the study?

Does combined ACE inhibition and AT1 receptor blockade improve LV myocyte function and excitation-contraction coupling in a pig model of pacing-induced heart failure?

Population

46 pigs randomly assigned to rapid atrial pacing (240 bpm) for 3 weeks or sham control

Comparison

ACE inhibition, AT1 receptor blockade, or… vs Rapid pacing only and sham controls

Design

Preclinical, randomly assigned

Follow-up

3 weeks

Authors

FSFrancis G. SpinaleHeart Failure & Transplant RMRupak MukherjeeMedical University of South Carolina JIJulie P. IanniniNovartis (Switzerland)

Discussion

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Implication

Hypothesis-generating in pacing-induced HF; leaves open whether combined ACEI/AT1 blockade improves myocyte function in patients.

Structured PICO

Does combined ACE inhibition and AT1 receptor blockade improve LV myocyte function and excitation-contraction coupling in a pig model of pacing-induced heart failure?

Population

46 pigs randomly assigned to rapid atrial pacing (240 bpm) for 3 weeks or sham control

Intervention

ACE inhibition (benazeprilat, 0.187 mg/kg/d), AT1 receptor blockade (valsartan, 3 mg/kg/d), or combined ACEI and AT1 blockade (benazeprilat/valsartan, 0.05/3 mg/kg/d) concomitant with rapid pacing for 3 weeks

Comparator

Rapid pacing only and sham controls

Outcome

Isolated LV myocyte function (shortening velocity, beta-adrenergic response) and components of excitation-contraction coupling (L-type Ca2+ channel density, sarcoplasmic reticulum Ca2+ ATPase density)surrogate

In a pig model of pacing-induced heart failure, combined ACE inhibition and AT1 receptor blockade reversed defects in myocyte excitation-contraction coupling and improved contractile function.

Cite This Study

Spinale et al. (1997) studied this question.

synapsesocial.com/papers/6a1cafa76552df3dce1d8930 https://doi.org/10.1161/01.cir.96.7.2397

Topics

Heart failure HFrEF treatment HFpEF management

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Modulation of the Renin-Angiotensin Pathway Through Enzyme Inhibition and Specific Receptor Blockade in Pacing-Induced Heart Failure

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Topics

Modulation of the Renin-Angiotensin Pathway Through Enzyme Inhibition and Specific Receptor Blockade in Pacing-Induced Heart Failure

Discussion

Member takes

Implication

Structured PICO

Cite This Study

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Topics

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