The Comparison of The Efficacy and The Confidence of The Vasodilator Therapy With Felodipine And Lisinopril in Chronic, Moderate to Severe Aortic Regurgitation
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چکیده
Gülten TAÇOY, Murat ÖZDEMIR, Yusuf TAVIL, Sedat TÜRKOGLU, Atiye ÇENGEL Gazi Üniversity Medical Faculty, Department of Cardiology, Ankara. SUMMARY Purpose: Afterload reduction decreases volume overload on the left ventricle in chronic asymptomatic aortic regurgitation (AR). In this prospective, randomized trial, we aimed to compare the effects of a 6-months long treatment with lisinopril versus felodipine on left ventricular function and hemodynamic parameters. Methods: 41 asymptomatic patients with moderate to severe chronic, isolated AR were randomly assigned to treatment with either lisinopril (20 mg) or felodipin (10 mg). Echocardiographic ([ESV], [EDV], [EF], [FSV], [LVSV], [RV], [RF], [FCO], [LVCO], [SW], [CW], [LVWS]) and hemodynamic parameters [SBP], [DBP], [SVR]) at baseline and at 6 months were compared. Results: At 6 months, with lisinopril, SBP 8,9 %, DBP 5,9 %, SVR 16,7 %, RV 8,4 %, RF 11 %, SW 6 %, CW 7.2 % decreased and FSV 11,2 %, LVSV 3 % increased (p<0.05). With felodipine, SBP 11,3 %, DKB 9,4 %, SVR 17,3 %, RF 9,7 %, SW 10,8 %, CW 8,9 % decreased and FSV 5,6 % increased ( p < 0.05). At the end of 6 months, the increase in FSV was significantly greater in the lisinopril group (p < 0.05) and the increase in heart rate was significantly greater in the felodipin group (p < 0.05). Conclusion: In chronic asymptomatic AR, a 6-months long treatment with either lisinopril or felodipin is associated with similar effects as assessed by echocardiography. The only difference in between the two drugs is a more profound increase in FSV with lisinopril and a more profound increase in HR with felodipin. Whether this difference makes any clinical sense needs confirmation with a larger population and a longer follow-up.
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تاریخ انتشار 2007