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Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy.
J Card Fail. 2007 Dec; 13(10):812-7.JC

Abstract

BACKGROUND

Heart rate variability (HRV) and heart rate turbulence are known to be disturbed and associated with excess mortality in heart failure. The aim of this study was to investigate whether losartan, when added on top of beta-blocker and angiotensin-converting enzyme inhibitor (ACEI) therapy, could improve these indices in patients with systolic heart failure.

METHODS AND RESULTS

Seventy-seven patients (mean age 60.4 +/- 8.0, 80.5% male) with ischemic cardiomyopathy (mean ejection fraction 34.5 +/- 4.4%) and New York Heart Association Class II-III heart failure symptoms, already receiving a beta-blocker and an ACEI, were randomly assigned to either open-label losartan (losartan group) or no additional drug (control group) in a 2:1 ratio and the patients were followed for 12 weeks. The HRV and heart rate turbulence indices were calculated from 24-hour Holter recordings both at the beginning and at the end of follow-up. The baseline clinical characteristics, HRV, and heart rate turbulence indices were similar in the 2 groups. At 12 weeks of follow-up, all HRV parameters except pNN50 increased (SDNN: 113.2 +/- 34.2 versus 127.8 +/- 24.1, P = .001; SDANN: 101.5 +/- 31.7 versus 115.2 +/- 22.0, P = .001; triangular index: 29.9 +/- 11.1 versus 34.2 +/- 7.9, P = .008; RMSSD: 29.1 +/- 20.2 versus 34.3 +/- 23.0, P = .009; NN50: 5015.3 +/- 5554.9 versus 6446.7 +/- 6101.1, P = .024; NN50: 5.65 +/- 6.41 versus 7.24 +/- 6.99, P = .089; SDNNi: 45.1 +/- 13.3 versus 50.3 +/- 14.5, P = .004), turbulence onset decreased (-0. 61 +/- 1.70 versus -1.24 +/- 1.31, P = .003) and turbulence slope increased (4.107 +/- 3.881 versus 5.940 +/- 4.281, P = .004) significantly in the losartan group as compared with controls.

CONCLUSIONS

A 12-week-long losartan therapy significantly improved HRV and heart rate turbulence in patients with Class II-III heart failure and ischemic cardiomyopathy already on beta-blockers and ACEI.

Authors+Show Affiliations

Gazi University School of Medicine, Department of Cardiology, Ankara, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18068613

Citation

Ozdemir, Murat, et al. "Losartan Improves Heart Rate Variability and Heart Rate Turbulence in Heart Failure Due to Ischemic Cardiomyopathy." Journal of Cardiac Failure, vol. 13, no. 10, 2007, pp. 812-7.
Ozdemir M, Arslan U, Türkoğlu S, et al. Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy. J Card Fail. 2007;13(10):812-7.
Ozdemir, M., Arslan, U., Türkoğlu, S., Balcioğlu, S., & Cengel, A. (2007). Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy. Journal of Cardiac Failure, 13(10), 812-7.
Ozdemir M, et al. Losartan Improves Heart Rate Variability and Heart Rate Turbulence in Heart Failure Due to Ischemic Cardiomyopathy. J Card Fail. 2007;13(10):812-7. PubMed PMID: 18068613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy. AU - Ozdemir,Murat, AU - Arslan,Uğur, AU - Türkoğlu,Sedat, AU - Balcioğlu,Serhat, AU - Cengel,Atiye, PY - 2007/04/12/received PY - 2007/07/31/revised PY - 2007/08/01/accepted PY - 2007/12/11/pubmed PY - 2008/1/18/medline PY - 2007/12/11/entrez SP - 812 EP - 7 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 13 IS - 10 N2 - BACKGROUND: Heart rate variability (HRV) and heart rate turbulence are known to be disturbed and associated with excess mortality in heart failure. The aim of this study was to investigate whether losartan, when added on top of beta-blocker and angiotensin-converting enzyme inhibitor (ACEI) therapy, could improve these indices in patients with systolic heart failure. METHODS AND RESULTS: Seventy-seven patients (mean age 60.4 +/- 8.0, 80.5% male) with ischemic cardiomyopathy (mean ejection fraction 34.5 +/- 4.4%) and New York Heart Association Class II-III heart failure symptoms, already receiving a beta-blocker and an ACEI, were randomly assigned to either open-label losartan (losartan group) or no additional drug (control group) in a 2:1 ratio and the patients were followed for 12 weeks. The HRV and heart rate turbulence indices were calculated from 24-hour Holter recordings both at the beginning and at the end of follow-up. The baseline clinical characteristics, HRV, and heart rate turbulence indices were similar in the 2 groups. At 12 weeks of follow-up, all HRV parameters except pNN50 increased (SDNN: 113.2 +/- 34.2 versus 127.8 +/- 24.1, P = .001; SDANN: 101.5 +/- 31.7 versus 115.2 +/- 22.0, P = .001; triangular index: 29.9 +/- 11.1 versus 34.2 +/- 7.9, P = .008; RMSSD: 29.1 +/- 20.2 versus 34.3 +/- 23.0, P = .009; NN50: 5015.3 +/- 5554.9 versus 6446.7 +/- 6101.1, P = .024; NN50: 5.65 +/- 6.41 versus 7.24 +/- 6.99, P = .089; SDNNi: 45.1 +/- 13.3 versus 50.3 +/- 14.5, P = .004), turbulence onset decreased (-0. 61 +/- 1.70 versus -1.24 +/- 1.31, P = .003) and turbulence slope increased (4.107 +/- 3.881 versus 5.940 +/- 4.281, P = .004) significantly in the losartan group as compared with controls. CONCLUSIONS: A 12-week-long losartan therapy significantly improved HRV and heart rate turbulence in patients with Class II-III heart failure and ischemic cardiomyopathy already on beta-blockers and ACEI. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/18068613/Losartan_improves_heart_rate_variability_and_heart_rate_turbulence_in_heart_failure_due_to_ischemic_cardiomyopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(07)01023-8 DB - PRIME DP - Unbound Medicine ER -