Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy

Oezdemir M., Arslan U., TÜRKOĞLU S., Balcioglu S., Cengel A.

JOURNAL OF CARDIAC FAILURE, cilt.13, sa.10, ss.812-817, 2007 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 10
  • Basım Tarihi: 2007
  • Doi Numarası: 10.1016/j.cardfail.2007.08.002
  • Dergi Adı: JOURNAL OF CARDIAC FAILURE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.812-817
  • Anahtar Kelimeler: systolic heart failure, losartan, ACUTE MYOCARDIAL-INFARCTION, CONVERTING ENZYME ACE, RANDOMIZED-TRIAL, CARVEDILOL THERAPY, NERVOUS-SYSTEM, ANGIOTENSIN-II, MORTALITY, CAPTOPRIL, CANDESARTAN, SECONDARY
  • Gazi Üniversitesi Adresli: Evet

Özet

Background: Heart rate variability (HRV) and heart rate turbulence are known to be disturbed and associated with excess mortality in heart failure. The aim of this study was to investigate whether losartan, when added on top of P-blocker and angiotensin-converting enzyme inhibitor (ACEI) therapy, could improve these indices in patients with systolic heart failure. Methods and Results: Seventy-seven patients (mean age 60.4 +/- 8.0, 80.5% male) with ischemic cardiomyopathy (mean ejection fraction 34.5 +/- 4.4%) and New York Heart Association Class II-III heart failure symptoms, already receiving a beta-blocker and an ACEI, were randomly assigned to either open-label losartan (losartan group) or no additional drug (control group) in a 2:1 ratio and the patients were followed for 12 weeks. The HRV and heart rate turbulence indices were calculated from 24-hour Holler recordings both at the beginning and at the end of follow-up. The baseline clinical characteristics, HRV, and heart rate turbulence indices were similar in the 2 groups. At 12 weeks of follow-up, all HRV parameters except pNN50 increased (SDNN: 113.2 +/- 34.2 versus 127.8 +/- 24.1, P = .001; SDANN: 101.5 +/- 31.7 versus 115.2 +/- 22.0, P =.001; triangular index: 29.9 +/- 11.1 versus 34.2 +/- 7.9, P =.008; RMSSD: 29.1 +/- 20.2 versus 34.3 +/- 23.0, P =.009; NN50: 5015.3 +/- 5554.9 versus 6446.7 +/- 6101.1, P =.024; NN50: 5.65 +/- 6.41 versus 7.24 +/- 6.99, P =.089; SDNNi: 45.1 +/- 13.3 versus 50.3 +/- 14.5, P =.004), turbulence onset decreased (-0.61 +/- 1.70 versus -1.24 +/- 1.31, P =.003) and turbulence slope increased (4.107 +/- 3.881 versus 5.940 +/- 4.281, P =.004) significantly in the losartan group as compared with controls. Conclusions: A 12-week-long losartan therapy significantly improved HRV and heart rate turbulence in patients with Class II-III heart failure and ischemic cardiomyopathy already on beta-blockers and ACEI.