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首页> 美国卫生研究院文献>Current Therapeutic Research Clinical and Experimental >A Single-Center Open-Label Randomized Parallel-Group Study Assessing the Differences Between an Angiotensin II Receptor Antagonist and an Angiotensin-Converting Enzyme Inhibitor in Hypertensive Patients with Congestive Heart Failure: The Research for Efficacy of Angiotensin II Receptor Antagonist in Hypertensive Patients with Congestive Heart Failure Study
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A Single-Center Open-Label Randomized Parallel-Group Study Assessing the Differences Between an Angiotensin II Receptor Antagonist and an Angiotensin-Converting Enzyme Inhibitor in Hypertensive Patients with Congestive Heart Failure: The Research for Efficacy of Angiotensin II Receptor Antagonist in Hypertensive Patients with Congestive Heart Failure Study

机译：评估充血性心力衰竭高血压患者血管紧张素II受体拮抗剂与血管紧张素转换酶抑制剂之间差异的单中心开放标签随机平行分组研究：高血压患者血管紧张素II受体拮抗剂的疗效研究充血性心力衰竭患者研究

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>Background: Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) have been used to treat congestive heart failure (CHF). According to a MEDLINE search, however, few studies are available on the clinical differences between ARBs and ACEIs in CHF.>Objective: To examine the clinical differences between an ARB (candesartan cilexetil) and an ACEI (lisinopril) in the treatment of CHF, we investigated exercise capacity, ventricular function, and neurohormonal levels in hypertensive patients with CHF before and after treatment with these agents.>Methods: Patients with symptoms of CHF (New York Heart Association functional class II–III and left ventricular ejection fraction [LVEF] ≤45%) complicated by hypertension (systolic blood pressure [BP] ≥140 mm Hg or diastolic BP ≥90 mm Hg) were eligible for this single-center, open-label, randomized, parallel-group study. They were given either the ARB or the ACEI for 24 weeks. A cardiopulmonary exercise test and echocardiography were performed. Clinical findings and cardiac events in addition to the CHF symptoms were investigated. Neurohormonal levels were measured before and after 24 weeks of treatment with the study drug. The primary end point of this study was exercise capacity, which was measured using peak oxygen consumption (VO2).>Results: Forty-two patients with CHF were enrolled and 38 (28 men, 10 women; mean [SD] age, 69.0 [8.2] years) completed the study. None of these patients had definite progression of the CHF symptoms. In the ARB-treated patients, mean (SD) peak VO2 (mL/min/kg) and LVEF (%) increased from 14.1 (2.9) to 15.3 (3.4) and from 34.4 (9.5) to 41.8 (9.5), respectively. In the ACEI group, the peak VO2 did not change, but the LVEF (%) increased from 34.2 (10.2) to 40.4 (13.0). However, the differences between ARB and ACEI were not clarified because of the possibility of a small sample size.>Conclusions: Although this study was not powered to show differences in efficacy between the ARB and ACEI in this study, our findings suggest that both ARB and ACEI had beneficial effects in hypertensive patients with CHF. Some unidentified differences in hemodynamic characteristics were found between the ARB and the ACEI groups.
机译：>背景：血管紧张素II受体阻滞剂（ARB）和血管紧张素转换酶抑制剂（ACEIs）已用于治疗充血性心力衰竭（CHF）。但是，根据MEDLINE搜索，关于瑞郎中ARB和ACEI之间的临床差异的研究很少。>目的：研究ARB（坎地沙坦cilexetil）和ACEI（赖诺普利）之间的临床差异。在CHF的治疗中，我们调查了这些药物治疗前后的高血压CHF患者的运动能力，心室功能和神经激素水平。>方法：患有CHF症状的患者（纽约心脏协会功能II级至III级且左心室射血分数[LVEF]≤45％）并伴有高血压（收缩压[BP]≥140mm Hg或舒张压BP≥90mm Hg）的患者，符合此单中心，开放标签，随机分组研究。他们接受了24周的ARB或ACEI治疗。进行了心肺运动试验和超声心动图检查。除了CHF症状外，还研究了临床发现和心脏事件。在用研究药物治疗24周之前和之后测量神经激素水平。这项研究的主要终点是运动能力，该运动能力是通过峰值耗氧量（VO2）进行测量的。>结果：42例CHF患者入组，其中38例（男性28例，女性10例；平均值[ SD]年龄（69.0 [8.2]岁）完成了研究。这些患者均未出现CHF症状的明确进展。在接受ARB治疗的患者中，平均（SD）峰值VO2（mL / min / kg）和LVEF（％）分别从14.1（2.9）增至15.3（3.4）和34.4（9.5）增至41.8（9.5）。在ACEI组中，VO2峰值不变，但LVEF（％）从34.2（10.2）增加到40.4（13.0）。但是，由于样本量较小，ARB和ACEI之间的差异尚未弄清。>结论：尽管本研究未能证明本研究中ARB和ACEI的疗效存在差异，我们的发现表明，ARB和ACEI均对高血压CHF患者具有有益作用。在ARB组和ACEI组之间发现了一些未确定的血液动力学特征差异。

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