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).
Cross-Sectional
Does the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers affect right ventricular structure and function in a multi-ethnic cohort?
ACEi/ARB use is associated with race-specific, LV-independent differences in right ventricular morphology, suggesting the renin-angiotensin system influences RV structure.
Effect estimate: Difference -0.7 g (95% CI -1.3 to -0.1)
p-value: p=0.03
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.
Ventetuolo et al. (2012) 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).