Format

Send to

Choose Destination
See comment in PubMed Commons below
JACC Heart Fail. 2013 Dec;1(6):480-7. doi: 10.1016/j.jchf.2013.09.001. Epub 2013 Oct 24.

Effects of losartan on left ventricular hypertrophy and fibrosis in patients with nonobstructive hypertrophic cardiomyopathy.

Author information

1
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
2
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
3
Cardiac MR PET CT Program, Department of Radiology and Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
4
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Howard Hughes Medical Institute, Boston, Massachusetts; Department of Genetics, Harvard Medical School, Boston, Massachusetts.
5
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: mfifer@partners.org.

Abstract

OBJECTIVES:

The aim of this study was to evaluate the effects of losartan on left ventricular (LV) hypertrophy and fibrosis in patients with nonobstructive hypertrophic cardiomyopathy (HCM).

BACKGROUND:

Despite evidence that myocardial hypertrophy and fibrosis are mediated by angiotensin II and are important determinants of morbidity and mortality in patients with HCM, no prior studies have evaluated the effects of angiotensin receptor blockers on LV hypertrophy and fibrosis with cardiac magnetic resonance imaging.

METHODS:

In double-blind fashion, 20 patients (3 women, 17 men; age: 51 ± 13 years) with HCM were randomly assigned to receive placebo (n = 9) or losartan 50 mg twice a day (n = 11) for 1 year. Cardiac magnetic resonance imaging was performed at baseline and 1 year to measure LV mass and extent of fibrosis as assessed by late gadolinium enhancement.

RESULTS:

There was a trend toward a significant difference in the percent change in LV mass (median [interquartile range]: +5% [-4% to +21%] with placebo vs. -5% [-11% to -0.9%] with losartan; p = 0.06). There was a significant difference in the percent change in extent of late gadolinium enhancement, with the placebo group experiencing a larger increase (+31% ± 26% with placebo vs. -23% ± 45% with losartan; p = 0.03).

CONCLUSIONS:

This pilot study suggests attenuation of progression of myocardial hypertrophy and fibrosis with losartan in patients with nonobstructive HCM. Confirmation of these results in a larger trial is required to confirm a place for angiotensin receptor blockers in the management of patients with HCM. (Effect of Losartan in Patients With Nonobstructive Hypertrophic Cardiomyopathy; NCT01150461).

KEYWORDS:

angiotensin II receptor blocker; cardiac magnetic resonance imaging; hypertrophic cardiomyopathy; late gadolinium enhancement; left ventricular fibrosis

PMID:
24621999
PMCID:
PMC3950308
DOI:
10.1016/j.jchf.2013.09.001
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center