To view the fulltext, please log in
To view the pdf, please log in
- FullText & PDF
- Unlimited re-access via MyKarger (new!)
- Unrestricted printing, no saving restrictions for personal use
- Reduced rates with a PPV account
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restriction apply
Rental: USD 8.50
Cloud: USD 20.00
- Automatic perpetual access to all articles of the subscribed year(s)
- Unlimited re-access via Subscriber Login or MyKarger
- Unrestricted printing, no saving restrictions for personal use
Article / Publication Details
Left ventricular hypertrophy (LVH) commonly occurs in patients with end-stage renal disease (ESRD) and is an independent risk factor for cardiovascular events. Angiotensin II type 1 receptor (AT1-R) antagonists may be able to reverse LVH independent to the hypotensive effect in the ESRD setting. Thirty chronically hemodialyzed uremic patients with hypertension were randomly assigned to receive the AT1-R antagonist losartan (n = 10), the angiotensin-converting enzyme (ACD) inhibitor enalapril (n = 10), or calcium antagonist amlodipine (n = 10). Left ventricular mass (LVM) index was measured by echocardiography before and 6 months after treatment. The baseline demographic and clinical characteristics did not differ between the three groups. The mean baseline LVM index also did not differ in the three groups. After 6 months of treatment, losartan treatment significantly reduced the LVM index (–24.7 ± 3.2%) than amlodipine (–10.5 ± 5.2%) or enalapril (–11.2 ± 4.1%) therapy. All three groups had a similar decrease in the mean blood pressure with treatment. The plasma angiotensin II concentration increased 5-fold with losartan treatment. In contrast, the plasma angiotension II concentration did not change with enalapril and only increased 2-fold with amlodipine. Thus, the present study indicates that losartan more effectively regresses LVH in patients with ESRD than do enalapril and amlodipine despite a comparable depressor effect between the three drugs.
Article / Publication Details
Copyright / Drug Dosage
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
- Shinzato T, Nakai S, Akiba T, Yamagami S, Yamazaki C, Kitaoka T, Kubo K, Maeda K, Morii H: Report of the annual statistical survey of the Japanese Society for Dialysis Therapy in 1996. Kidney Int 1999;55:700–712.
- Geerling W, Tufveson G, Broyer M, Brunner FP, Brynger H, Fassbinder W: Combined report on regular dialysis and transplantation in Europe. Proc Eur Dial Transplant Assoc 1983;17:52–54.
- Harnett JD, Parfrey PS, Griffiths SM, Gault MH, Barre P, Guttmann RD: Left ventricular hypertrophy in end-stage renal disease. Nephron 1988;48:107–115.
- Cannella G, Paoletti E, Delfino R, Peloso G, Molinari S, Traverso GB: Regression of left ventricular hypertrophy on hypertensive dialyzed uremic patients on long-term antihypertensive therapy. Kidney Int 1993;44:881–886.
- Matsubara H: Pathophysiological role of angiotensin II type 2 receptor in cardiovascular and renal diseases. Circ Res 1998;83:1182–1191.
- Shibasaki Y, Mori Y, Tsutsumi Y, Masaki H, Sakamoto K, Murasawa S, Maruyama K, Moriguchi Y, Tanaka Y, Iwasaka T, Inada M, Matsubara H: Differential kinetics of circulating angiotensin IV and II after treatment with angiotensin II type 1 receptor antagonist and their plasma levels in patients with chronic renal failure. Clin Nephrol 1999;51:83–91.
- Sahn DJ, Demaria A, Kisslo J, Weyman A: Recommendations regarding quantitation in M-mode echocardiography: Results of survey of echocardiographic measurements. Circulation 1978;58:1072–1083.
- Schiller NB, Shah PM, Crawford M, Demaria A, Devereux R, Feigenbaum Reichek N, Sahn D, Schnittger I, Silverman NH, Tajik AJ: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989;2:358–367.
- Harnett JD, Murphy B, Collingwood P, Purchase L, Kent G, Parfrey PS: The reliability and validity of echocardiographic measurement of left ventricular mass index in hemodialysis patients. Nephron 1993;65:212–214.
- Ando Y, Yanagiba S, Asano Y: The inferior vena cava diameter as a marker of dry weight in chronic hemodialyzed patients. Artif Organs 1995;19:1237–1242.
- Fernandez JM, Carbonell ME, Mazzuchi N, Petruccelli D: Simultaneous analysis of morbidity and mortality factors in chronic hemodialysis patients. Kidney Int 1992;41:1029–1034.
- Kimura G, Tomita J, Nakamura S, Uzu T, Inenaga T: Interaction between hypertension and other cardiovascular risk factors in survival of hemodialyzed patients. Am J Hypertens 1996;9:1006–1012.
- Folet RN, Parfrey PS, Harnett JD, Kent GM, Martin CJ, Murray DC, Barre PE: Clinical and echocardiographic disease in patients starting end-stage renal disease therapy. Kidney Int 1995;47:186–192.
- Silberberg JS, Barre PE, Prichard SS, Sniderman AD: Impact of left ventricular hypertrophy on survival in end-stage renal disease. Kidney Int 1989;36:286–290.
- Parfrey PS, Griffiths SM, Harnett JD, Taylor R, King A, Hand J, Barre PE: Outcome of congestive heart failure, dilated cardiomyopathy, hypertrophic hyperkinetic disease and ischemic heart disease in dialysis patient. Am J Nephrol 1990;10:213–221.
- Cannella G, Paoletti E, Delfino R, Peloso G, Rolla D, Molinari S: Prolonged therapy with ACE inhibitors induced a regression of left ventricular hypertrophy of dialyzed uremic patients independently from hypotensive effects. Am J Kidney Dis 1997;30:659–664.
- Roithinger FX, Punzengruber C, Wallner M, Ulbrich W, Pachinger O, Kramar R, Prischl FC: The influence of ACE inhibition on myocardial mass and diastolic function in chronic hemodialysis patients with adequate control of blood pressure. Clin Nephrol 1994;2:309–314.
- Cuspidi C, Lonati L, Sampieri L, Valagussa L, Macca G, Leonetti G, Zachetti A: Effects of losartan on blood pressure and left ventricular mass in essential hypertension. High Blood Press 1998;7:75–79.
- Thürmann PA, Kenedi PK, Schmidt A, Harder S, Rietbrock N: Influence of angiotensin II antagonist Valsartan on left ventricular hypertrophy in patients with essential hypertension. Circulation 1998;98:2037–2042.
- Himmelmann A, Svensson A, Dahlof B, Bergbrant A, Hansson L: Losartan in essential hypertension: Effects on blood pressure and left ventricular mass. High Blood Press 1995;4:242–248.
- Himmelsmann A, Svensson A, Bergbrant A, Hansson L: Long-term effects of losartan on blood pressure and left ventricular structure in essential hypertension. J Hum Hypertens 1996;10:729–734.
- Cheung B: Increased left ventricular mass after losartan treatment. Lancet 1997;349:1743–1744.
- Assanelli D, Cannella G, Guerra UP, Cuminetti S, Gaggiotti M, Sandrini M: Effects of intravascular volume loading and unloading on atrial sizes and left ventricular function in dialyzed uremic man. Am J Noninvas Cardiol 1990;4:53–59.
- Silbergerg JS, Barre PE, Prichard SS, Sniderman AD: Role of anemia in pathogenesis of left ventricular hypertrophy in end-stage renal disease. Am J Cardiol 1989;64:222–224.
- Martinez-Vea A, Bardaji A, Garcia C, Ridao C, Richart C, Oliver JA: Long-term myocardial effects of correction of anemia with recombinant human erythropoietin in aged patients on hemodialysis. Am J Kidney Dis 1992;19:353–357.
- Washio M, Okuda S, Mizoue T, Kiyama S, Sanai T, Hirakata H, Nanishi F, Kiyohara C, Ogimoto I, Yoshimura T, Fujishima M: Risk factors for left ventricular hypertrophy in chronic hemodialysis patients. Clin Nephrol 1997;47:362–366.
- London GM, De Vernejoul MC, Fabiani F, Marchais SJ, Guerin AP, Metivier F, London AM, Llach F: Secondary hyperparathyroidism and cardiac hypertrophy in hemodialysis patients. Kidney Int 1987;32:900–907.
- Laragh JH: Renin profiling for diagnosis, risk assessment, and treatment of hypertension. Kidney Int 1993;44:1163–1175.
- Vlahakos DV, Hahalis G, Vassilakos P, Marathias KP, Geroulanos S: Relationship between left ventricular hypertrophy and plasma renin activity in chronic hemodialysis patients. J Am Soc Nephrol 1997;8:1764–1770.
- Suzuki J, Matsubara H, Inada M: Rat angiotensin II (type 1A) receptor mRNA regulation and subtype expression in myocardial growth and hypertrophy. Circ Res 1993;73:439–447.
- Kijima K, Matsubara H, Murasawa S, Muruyama K, Mori Y, Ohkubo N, Komuro I, Yazaki Y, Iwasaka T, Inada M: Mechanical stretch induces enhanced expression of angiotensin II receptor subtypes in neonatal rat cardiac myocytes. Circ Res 1996;79:887–897.
- Urata H, Healy B, Stewart RW, Bumpus FM, Husain A: Angiotension II-forming pathways in normal and failing human hearts. Circ Res 1990;66:883–890.
- Low-Friedrich I, Grutzmacher P, Marz W, Bergmann M, Schoeppe W: Therapy with recombinant human erythropoietin reduced cardiac size and improves heart function in chronic hemodialysis patients. Am J Nephrol 1991;11:54–60.
- Londin GM, Zins B, Pannier B, Naret C, Berthelot JM, Jacquot C, Safer M, Drueke TB: Vascular change in hemodialysis patients in response to recombinant human erythropoietin. Kidney Int 1989;36:878–882.
- Silberberg JS, Racine N, Barre PE, Sniderman AD: Regression of left ventricular hypertrophy in dialysis patients following correction of anemia with recombinant human erythropoietin. Can J Cardiol 1992;6:1–4.