- 作者：Leo Chi-Chiu Kum ; Gabriel Wai-Kwok Yip ; Pui-Wai Lee ; Yat-Yin Lam ; Eugene B. Wu ; Anna Kin-Yin Chan ; Jeffrey Wing-Hong Fung ; Joseph Yat-Sun Chan ; Qing Zhang ; Shun-Ling Kong ; Cheuk-Man Yu
- 关键词：Heart failure ; Angiotensin-converting enzyme inhibitor ; Angiotensin receptor blocker ; Echocardiography
- 刊名：International Journal of Cardiology
- 出版年：2008
- 出版时间：28 March 2008
- 年：2008
- 卷：125
- 期：1
- 页码：16-21
- 全文大小：174 K
Design
Randomized control trial.
Setting
Single center.
Patients
50 CHF patients on stable doses of ACEI.
Interventions
Add-on therapy with irbesartan (300 mg/day) or continuation of conventional therapy (control group) for 1 year.
Main outcome measures
Serial clinical and echocardiographic assessment were performed as baseline, 3 months and 1 year after therapy.
Results
There was no difference in clinical characteristics between 2 groups. Patients in the add-on therapy group had significant increase in 6-Minute Hall-Walk distance (351 ± 89 to 392 ± 84 m, P < 0.01), achieved higher METs exercise time on treadmill test (3.9 ± 1.1 to 4.6 ±1.3 METs, P = 0.01), reduction of NYHA Class (2.4 ± 0.5 to 2.0 ± 0.8, P < 0.005) and improvement of QOL score (28 ± 19 to 17 ± 18, P < 0.05). These parameters were not improved in the control group and a worsening of exercise capacity was observed (P < 0.05). A reduction of left ventricular end-systolic diameter (4.94 ± 0.85 vs 4.30 ± 1.17 cm, P < 0.05) was observed in the add-on group. At the end of 1 year, more patients have normal or abnormal relaxation pattern in the add-on group than the control group (82 % vs 53 % χ2 = 7.1, P = 0.02). Blood pressure and renal function were unchanged in both groups.
Conclusion
The addition of irbesartan to conventional ACEI therapy in CHF further improves symptoms, exercise capacity and quality of life without adverse effects on hemodynamics and renal function.