TY - JOUR
T1 - Neurohormonal reactivation in heart failure patients on chronic ACE inhibitor therapy
T2 - a longitudinal study
AU - Lee, Alison F. C.
AU - MacFadyen, Robert J.
AU - Struthers, Allan D.
PY - 1999
Y1 - 1999
N2 - Angiotensin Converting Enzyme inhibitors reduce mortality in heart failure. One therapeutic mechanism is believed to be the reduction of circulating angiotensin II and aldosterone. However, the Renin-Angiotensin-Aldosterone axis (RAAS) is not uniformly suppressed during therapy for heart failure. This effect has been referred to as 'angiotensin II reactivation' and 'aldosterone escape' and their reactivation may herald clinical deterioration. In the CONSENSUS I trial, correlations were seen between mortality, and angiotensin II and aldosterone. Furthermore, mortality was lower in those with good angiotensin II suppression. Therefore, neurohormonal elevation despite adequate treatment may associate with a poorer prognosis.
AB - Angiotensin Converting Enzyme inhibitors reduce mortality in heart failure. One therapeutic mechanism is believed to be the reduction of circulating angiotensin II and aldosterone. However, the Renin-Angiotensin-Aldosterone axis (RAAS) is not uniformly suppressed during therapy for heart failure. This effect has been referred to as 'angiotensin II reactivation' and 'aldosterone escape' and their reactivation may herald clinical deterioration. In the CONSENSUS I trial, correlations were seen between mortality, and angiotensin II and aldosterone. Furthermore, mortality was lower in those with good angiotensin II suppression. Therefore, neurohormonal elevation despite adequate treatment may associate with a poorer prognosis.
U2 - 10.1016/S1388-9842(99)00046-X
DO - 10.1016/S1388-9842(99)00046-X
M3 - Article
C2 - 10937954
SN - 1388-9842
VL - 1
SP - 401
EP - 406
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 4
ER -