Neurohormonal reactivation in heart failure patients on chronic ACE inhibitor therapy: a longitudinal study

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 -