PDF icon PDF herunterladen
Int J Angiol 2021; 30(02): 122-131
DOI: 10.1055/s-0041-1723948
Original Article

l-Arginine Can Enhance the Beneficial Effect of Losartan in Patients with Chronic Aortic Regurgitation and Isolated Systolic Hypertension

Shoa-Lin Lin‡   *
1   Division of Cardiology, Yuan's General Hospital, Kaohsiung City, Taiwan
,
Mike Lin‡   *
2   Department of Medicine, Gou-Zen Hospital, Pingtong City, Taiwan
,
Kuei-Liang Wang
3   An-Fa Institution of Preventive Medicine, Taipei, Taiwan
,
Hsien-Wen Kuo
4   Institute of Occupation and Environment Health Science, National Yang-Ming University, Taipei, Taiwan
,
Tahir Tak
5   Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
› Institutsangaben
Funding An-Fa Institution of Preventive MedicineAFSR 2010-2Yuan's General Hospital, Kaohsiung City, TaiwanYGH17 - 010
› Weitere Informationen
   Lizenzen und Reprints
Preview

Abstract

Information about the effects of angiotensin II receptor blocker (ARB) therapy on the hemodynamic and cardiac structure in patients with chronic aortic regurgitation (CAR) and isolated systolic hypertension (ISH) is limited.

This study planned to test the hypothesis that l-arginine could further enhance the beneficial effect of an ARB, losartan, and provide a favorable effect on the natural history of CAR and ISH.

Sixty patients with CAR and ISH were enrolled in a randomized, double-blind trial comparing hemodynamic and ultrasonic change in two treatment arms: losartan + l-arginine and losartan-only treated groups. Serial echocardiographic and hemodynamic studies were evaluated before and after treatment.

Both groups had a significant reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), left ventricular end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), LV mass index (LVMI), and LV mean wall stress after 6- and 12-month treatment (p <0.01 in all comparisons). Both groups had a significant increase in LV ejection fraction and exercise duration after 6- and 12-month treatment (p < 0.01 in all comparisons). Using multivariate linear regression analysis, only losartan + l-arginine therapy achieved a significantly lower LVESVI (38.89 ± 0.23 mL/m2), LVEDVI (102.3 ± 0.3 mL/m2), LVMI (107.6 ± 0.3 g/m2), SBP (123.5 ± 1.0 mm Hg), and greater exercise duration (7.38 ± 0.02 minutes) than those of the losartan-only treated groups (p <0.01 in all comparisons).

These findings suggest that early co-administrative strategy provides a beneficial approach to favorably influence the natural history of CAR.

Keywords

aortic regurgitation - isolated systolic hypertension - left ventricular mass - echocardiography - l-arginine

Disclosures

All authors have no conflicts of interest to disclose.


* Contributed equally to this work.




Publikationsverlauf

Artikel online veröffentlicht:
11. Mai 2021

© 2021. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA