Mazayev V P, Fomina I G, Kazakov E N, Sulimov V A, Zvereva T V, Lyusov V A, Orlov V A, Olbinskaya L I, Bolshakova T D, Sullivan J, Spormann D O
Scientific Centre for Preventive Medicine, Moscow, Russia.
Int J Cardiol. 1998 Aug;65(3):239-46. doi: 10.1016/s0167-5273(98)00149-1.
To evaluate the effect on cardiac hemodynamic parameters of valsartan in patients with chronic stable congestive heart failure previously untreated with ACE inhibitors.
After a 2 to 4 week run-in period, 116 adult outpatients were randomized to receive valsartan 40, 80 or 160 mg twice daily, the ACE inhibitor lisinopril 5/10 mg once daily, or placebo. At baseline and after 28 days of treatment, cardiac hemodynamic parameters were measured. Tolerability was assessed by adverse events and by any changes in systolic or diastolic blood pressure, body weight, heart rate, and routine laboratory parameters.
For the 12 hour time point (trough), all doses of valsartan reduced mean pulmonary capillary wedge pressure (statistically significant for valsartan 40 mg and 160 mg), decreased systemic vascular resistance (statistically significant for all three valsartan doses and for lisinopril at peak and trough), and increased cardiac output (statistically significant for all three valsartan doses at peak, and for 80 and 160 mg at trough). There were no clinically relevant effects on any safety parameters.
Valsartan has beneficial effects on cardiac hemodynamics, and is generally well tolerated in patients with congestive heart failure not taking ACE inhibitors.
评估缬沙坦对既往未接受过ACE抑制剂治疗的慢性稳定型充血性心力衰竭患者心脏血流动力学参数的影响。
经过2至4周的导入期后，116例成年门诊患者被随机分为接受缬沙坦40、80或160毫克每日两次，ACE抑制剂赖诺普利5/10毫克每日一次，或安慰剂。在基线和治疗28天后，测量心脏血流动力学参数。通过不良事件以及收缩压或舒张压、体重、心率和常规实验室参数的任何变化来评估耐受性。
在12小时时间点（谷值），所有剂量的缬沙坦均降低了平均肺毛细血管楔压（缬沙坦40毫克和160毫克具有统计学意义），降低了全身血管阻力（所有三个缬沙坦剂量以及赖诺普利在峰值和谷值时均具有统计学意义），并增加了心输出量（所有三个缬沙坦剂量在峰值时具有统计学意义，80毫克和160毫克在谷值时具有统计学意义）。对任何安全参数均无临床相关影响。
缬沙坦对心脏血流动力学具有有益作用，并且在未服用ACE抑制剂的充血性心力衰竭患者中通常耐受性良好。
