Comparison of Active Renin Concentration and Plasma Renin Activity as a Prognostic Predictor in Patients With Heart Failure

Tsutamoto, Takayoshi; Sakai, Hiroshi; Tanaka, Toshinari; Fujii, Masazumi; Yamamoto, Takashi; Wada, Atsuyuki; Ohnishi, Masato; Horie, Minoru

doi:10.1253/circj.71.915

Cited by 36 publications

(34 citation statements)

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“…[12][13][14][15][16] In addition, plasma levels of cardiac natriuretic peptides such as atrial natriuretic peptide and brain natriuretic peptide (BNP) are well-established powerful risk markers in CHF. 11,[17][18][19][20][21] The present study was to evaluate the comparative effects of perindopril with enalapril on cardiac sympathetic nerve activity (CSNA) evaluated using MIBG parameters and plasma BNP in CHF patients who have already received standard therapy, including carvedilol and spironolactone.…”

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confidence: 99%

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

Tsutamoto

Tanaka

Nishiyama

et al. 2008

Circ J

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BackgroundIn patients with chronic heart failure (CHF), it remains unclear whether perindopril is more cardioprotective than enalapril. Methods and Results Forty-five stable CHF outpatients undergoing conventional therapy including enalapril therapy were randomized to 2 groups [group I (n=24): continuous enalapril treatment; group II (n=21): enalapril was changed to perindopril]. Cardiac sympathetic nerve activity was evaluated using cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphy, hemodynamic parameters and neurohumoral factors before and 6 months after treatment. There was no difference in baseline characteristics between the 2 groups. In group I, there were no changes in MIBG parameters, left ventricular ejection fraction (LVEF) or plasma level of brain natriuretic peptide (BNP). In contrast, in group II the delayed heart/mediastinum count ratio was significantly increased (2.0±0.07 vs 2.15±0.07, p=0.013) and the washout rate was significantly decreased (33.0±1.4 vs 30.5±1.2, p=0.030) after 6 months compared with the baseline value. In addition, LVEF was significantly increased and the plasma BNP level was significantly decreased. Conclusion These findings suggest that for the treatment of CHF, perindopril is superior to enalapril with respect of cardiac sympathetic nerve activity and BNP. (Circ J 2008; 72: 740 -746)

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confidence: 99%

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

Tsutamoto

Tanaka

Nishiyama

et al. 2008

Circ J

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“…In patients with CHF, high plasma levels of PRC, Ang II, ALD and BNP were associated with poor prognosis. 17,18,28,29 Most biomarkers, except Ang II, did not change after replacement of candesartan with olmesartan. A high plasma Ang II level is a prognostic predictor in asymptomatic CHF patients 28 and in mild-to-moderate CHF patients.…”

Section: Discussionmentioning

confidence: 90%

“…The plasma levels of PRC, Ang II and ALD were measured using commercial radioimmunoassay kits as previously reported. 15,17 Samples for the assay of plasma BNP concentrations were transferred to chilled disposable tubes containing aprotinin (500 kallikrein inactivator units ml À1 ). The blood samples were immediately placed on ice and centrifuged at 4 1C, and then the plasma was frozen in aliquots and stored at À30 1C until assay.…”

Section: Measurement Of Neurohumoral Factorsmentioning

confidence: 99%

Comparison of the long-term effects of candesartan and olmesartan on plasma angiotensin II and left ventricular mass index in patients with hypertension

et al. 2009

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In general, treatment with most angiotensin receptor blockers (ARBs) increases plasma angiotensin II (Ang II) level because of a lack of negative feedback on renin activity. Olmesartan is a potential ARB inducing activation of angiotensin-converting enzyme 2 (ACE2) that hydrolyzes Ang II to Ang 1-7, and has shown a beneficial effect on ventricular remodeling. Indeed, a previous study reported that olmesartan treatment resulted in decreased plasma levels of Ang II and aldosterone. However, there has not yet been a study showing the relationship of chronic effects of olmesartan on Ang II and the left ventricular mass index (LVMI) in comparison with those of other ARB. A total of 50 stable outpatients with essential hypertension who had received candesartan for more than 1 year were randomized into two groups: control group (n¼25): continuous candesartan treatment at a stable dose; and olmesartan group (n¼25): candesartan (8 mg day À1 ) was changed to olmesartan given at a dose of 20 mg day À1 . There was no difference in the baseline characteristics between the two groups. In the control group, there were no significant changes in blood pressure, LVMI or biomarkers during 12 months of study. In the olmesartan group, blood pressure did not change and plasma levels of Ang II decreased during 12 months of study, whereas LVMI was significantly decreased after 12 months (135 ± 36 vs. 123 ± 29 g m À2 ; Po0.01). These findings indicate that replacing candesartan with olmesartan decreased LVMI in association with a sustained decrease of plasma Ang II over a 12-month period without changing blood pressure or plasma aldosterone in patients with essential hypertension.

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“…Chronic RAAS activation leads to persistent hypertension, setting off a cascade of inflammatory, thrombotic, and atherogenic effects eventually leading to end-organ damage (4,5). Accordingly, numerous studies have demonstrated that elevated aldosterone levels are predictors of adverse outcome in hypertension (6), heart failure (7,8), myocardial infarction (9), and renal insufficiency (10). Primary aldosteronism (PA) is the most common secondary form of hypertension with an estimated prevalence of around 4% in hypertensive patients in primary care and around 10% in those referred to specialized centers (11).…”

Section: Clinical Backgroundmentioning

confidence: 99%

EJE Prize 2013: Regulation of aldosterone secretion: from physiology to disease

Beuschlein

2013

European Journal of Endocrinology

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Arterial hypertension is a major cardiovascular risk factor that affects between 10 and 40% of the population in industrialized countries. Primary aldosteronism (PA) is the most common form of secondary hypertension with an estimated prevalence of around 10% in referral centers and 4% in a primary care setting. Despite its high prevalence until recently, the underlying genetic and molecular basis of this common disease had remained largely obscure. Over the past decade, a number of insights have been achieved that have relied on in vitro cellular systems, wild-type and genetically modified in vivo models, as well as clinical studies in well-characterized patient populations. This progress has been made possible by a number of independent technical developments including that of specific hormone assays that allow measurement in small sample volumes as well as genetic techniques that enable high-throughput sequencing of a large number of samples. Furthermore, animal models have provided important insights into the physiology of aldosterone regulation that have served as a starting point for investigation of mechanisms involved in autonomous aldosterone secretion. Finally, national and international networks that have built up registries and biobanks have been instrumental in fostering translational research endeavors in PA. Therefore, it is to be expected that in the near future, further pathophysiological mechanisms that result in autonomous aldosterone secretion will be unraveled. European Journal of Endocrinology 168 R85-R93

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Comparison of Active Renin Concentration and Plasma Renin Activity as a Prognostic Predictor in Patients With Heart Failure

Cited by 36 publications

References 35 publications

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

Beneficial Effect of Perindopril on Cardiac Sympathetic Nerve Activity and Brain Natriuretic Peptide in Patients With Chronic Heart Failure Comparison With Enalapril

Comparison of the long-term effects of candesartan and olmesartan on plasma angiotensin II and left ventricular mass index in patients with hypertension

EJE Prize 2013: Regulation of aldosterone secretion: from physiology to disease

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