Angiotensin II converting enzyme inhibition improves survival, ventricular remodeling and myocardial energetics in experimental aortic regurgitation.

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dc.contributor.authorArsenault, Marie-
dc.contributor.authorZendaoui, Adnane-
dc.contributor.authorRoussel, Élise-
dc.contributor.authorDrolet, Marie-Claude-
dc.contributor.authorDhahri, Wahiba-
dc.contributor.authorGrenier, Audrey-
dc.contributor.authorGascon, Suzanne-
dc.contributor.authorSarrhini, Otman-
dc.contributor.authorRousseau, Jacques A.-
dc.contributor.authorLecomte, Roger-
dc.contributor.authorCouët, Jacques-
dc.description.abstractBackground— Aortic valve regurgitation (AR) is a volume-overload disease causing severe eccentric left ventricular (LV) hypertrophy and eventually heart failure. There is currently no approved drug to treat patients with AR. Many vasodilators including angiotensin-converting enzyme inhibitors have been evaluated in clinical trials, but although some results were promising, others were inconclusive. Overall, no drug has yet been able to improve clinical outcome in AR and the controversy remains. We have previously shown in an animal model that captopril (Cpt) reduced LV hypertrophy and protected LV systolic function, but we had not evaluated the clinical outcome. This protocol was designed to evaluate the effects of a long-term Cpt treatment on survival in the same animal model of severe aortic valve regurgitation. Methods and Results—Forty Wistar rats with AR were treated or untreated with Cpt (1 g/L in drinking water) for a period of 7 months to evaluate survival, myocardial remodeling, and function by echocardiography as well as myocardial metabolism by µ positron emission tomography scan. Survival was significantly improved in Cpt-treated animals with a survival benefit visible as soon as after 4 months of treatment. Cpt reduced LV dilatation and LV hypertrophy. It also significantly improved the myocardial metabolic profile by restoring the level of fatty acids metabolic enzymes and use. Conclusions—In a controlled animal model of pure severe aortic valve regurgitation, Cpt treatment reduced LV remodeling and LV hypertrophy and improved myocardial metabolic profile and survival. These results support the need to reevaluate the role of angiotensin-converting enzyme inhibitors in humans with AR in a large, carefully designed prospective clinical
dc.publisherLippincott Williams & Wilkinsfr
dc.subjectAortic regurgitationfr
dc.subjectLeft ventriclefr
dc.subjectVolume overloadfr
dc.subjectAortic valve insufficiencyfr
dc.subjectHeart ventriclesfr
dc.titleAngiotensin II converting enzyme inhibition improves survival, ventricular remodeling and myocardial energetics in experimental aortic
dc.typeCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherchefr
dcterms.bibliographicCitationCirculation. Heart failure, Vol. 6 (5), 1021–1028 (2013)fr
dc.subject.rvmAngiotensine IIfr
dc.subject.rvmEnzyme de conversion de l'angiotensine -- Inhibiteursfr
dc.subject.rvmInsuffisance aortiquefr
dc.subject.rvmRemodelage ventriculairefr
dc.subject.rvmCœur -- Ventricule gauche -- Hypertrophiefr
dc.subject.rvmMyocarde -- Métabolismefr
dc.subject.rvmRats (Animaux de laboratoire)fr
rioxxterms.versionAccepted Manuscriptfr
rioxxterms.project.funder_nameCanadian Institutes of Health Researchfr
rioxxterms.project.funder_nameHeart and Stroke Foundation of Canadafr
rioxxterms.project.funder_nameInstitut universitaire de cardiologie et de pneumologie de Québec Foundationfr
bul.rights.periodeEmbargo6 moisfr
Collection:Articles publiés dans des revues avec comité de lecture

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