Effects of Angiotensin II Receptor Blockers on Ventricular Hypertrophy in Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials

Liu, Ye; Teramoto, Koji; Wing, V.; Supasiri, Thanan; Yin, Kanhua

doi:10.1007/s10557-020-07118-2

Cited by 9 publications

(7 citation statements)

References 39 publications

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“…Another study with 51 consecutive patients with HOCM who underwent ASA found that older individuals experienced the same advantages as younger patients following the procedure; however, they experienced greater mortality events than younger patients [ 59 ]. Liebregts et al reported data consistent with the aforementioned findings [ 32 , 33 , 40 , 42 , 46 , 49 , 50 , 52 - 63 ].…”

Section: Alcohol Septal Ablationsupporting

confidence: 67%

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A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

Menezes

Oliveira

Taia

et al. 2023

CCR

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Hypertrophic obstructive cardiomyopathy is a hereditary condition that affects myocardial contraction. In case of failure of pharmacological treatment, alternative approaches might be used that include surgical myectomy, percutaneous transluminal septal myocardial ablation, and radiofrequency ablation. In respect of long-term advantages, surgical septal myectomy remains the therapy of choice for symptomatic hypertrophic obstructive cardiomyopathy. Alcohol septal ablation has been considered an alternative to surgical myectomy, which confers the benefits of a shorter hospital stay, less discomfort, and fewer complications. However, only expert operators should perform it on carefully chosen patients. Further, radiofrequency septal ablation reduces the left ventricular outflow tract gradient and improves the NYHA functional class of patients with hypertrophic obstructive cardiomyopathy, despite complications like cardiac tamponade and atrioventricular block. Further research with a larger sample size is required to compare the radiofrequency approach with established invasive treatment methods for hypertrophic obstructive cardiomyopathy. Septal myectomy has low morbidity and mortality rates, making it the preferred procedure; however, the efficacy and morbidity remain debatable. Advances in invasive techniques, including percutaneous septal radiofrequency ablation and transcatheter myotomy, have provided alternative approaches for reducing left ventricular outflow tract (LVOT) obstruction in patients who are not candidates for traditional surgical septal myectomy. Candidates for alcohol and radiofrequency septal ablation include patients with symptomatic hypertrophic obstructive cardiomyopathy, older adults, and those with multiple comorbidities.

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Section: Alcohol Septal Ablationsupporting

confidence: 67%

“…The risk of arrhythmogenicity associated with ASA is a persistent concern [ 46 - 48 ]. Several doctors and HCM specialists, as well as guidelines and consensus committees, raise this issue regularly [ 49 ]. Further, the signs and symptoms of ASA also need to be addressed.…”

Section: Alcohol Septal Ablationmentioning

confidence: 99%

A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

Menezes

Oliveira

Taia

et al. 2023

CCR

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“…Previously available data failed to show the efficacy of ARB therapy in patients with established HCM [ 2 , 9 , 10 , 11 , 12 , 20 ]. Of note, many of these studies had several limitations, including smaller sample size and a shorter duration of follow-up (up to one year) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…A previously published meta-analysis by Liu et al . [ 13 ] comprising those RCTs also concluded no net benefits of ARBs on ventricular hypertrophy in hypertrophic cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Angiotensin II Receptor Blockers in Patients with Hypertrophic Cardiomyopathy: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

Abdelazeem¹,

Abbas²,

Ahmad³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Angiotensin receptor blocker (ARB) therapy has been evaluated to slow down the disease progression in patients with hypertrophic cardiomyopathy (HCM), but there is scarce evidence available to date. Therefore, our meta-analysis aimed to explore the efficacy of ARB therapy as a potential disease-modifying treatment in patients with HCM. Methods: A literature search was performed using PubMed, Scopus, Web of Science, Embase, Cochrane library, and Clinicaltrials.gov databases from inception to December 13th, 2021. We included only randomized controlled trials (RCTs). The quality of included studies was assessed by the Cochrane Collaboration’s tool. Primary outcomes included the reduction in left ventricular mass and improvement in other echocardiographic features of myocardial dysfunction. The secondary outcome was a net reduction in systolic blood pressure. Meta-analysis was performed using pooled standardized mean difference (SMD) and corresponding 95% confidence interval (CI). Results: A total of 1286 articles were screened. Seven RCTs met the inclusion criteria representing a total of 397 patients with HCM (195 patients were in the ARB group). ARB treatment was associated with significant reduction in left ventricular mass (SMD: –0.77; 95% CI: –1.40, –0.03; p = 0.04). ARB therapy was also associated with a significant reduction in systolic blood pressure (SMD: –0.33; 95% CI: –0.61, –0.05: p = 0.02). Conclusions: ARB therapy is associated with a marked reduction in left ventricular mass and systolic blood pressure in patients with hypertrophic cardiomyopathy. We recommend further studies with a larger patient population size to confirm the findings of our meta-analysis. Clinical Trial Registration: OSF Registries, DOI: 10.17605/OSF.IO/DAS7C .

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“…Increased activation of the angiotensinergic system ultimately contributes to cardiomyocyte hypertrophy and interstitial fibrosis. − Even though these deleterious effects could be, theoretically, mitigated via the use of angiotensin receptor blockers (ARBs) and/or angiotensin-converting enzyme inhibitors (ACEi), their clinical benefits remain controversial in the context of altering disease progression. Meta-analyses showed that ARBs and ACEi effectiveness in reducing maladaptive heart remodeling is modest, and improvements to patient quality of life and overall survival are not evident. − Due to its central role in the physiology and pathophysiology of the heart, the search for new strategies to target AT 1 Rs continues to be a promising avenue. The recent understanding of new mechanisms of receptor activation, such as biased signaling and location bias, open new opportunities to target AT 1 Rs in distinct ways.…”

Section: Introductionmentioning

confidence: 99%

G Protein-Biased Agonists for Intracellular Angiotensin Receptors Promote Collagen Secretion in Myofibroblasts

Dallagnol,

Volkovich,

Chatenet

et al. 2023

ACS Chem. Biol.

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Photoactivatable ligands remain valuable tools to study the spatiotemporal aspects of cellular signaling. However, the synthesis, handling, and biological validation of such compounds remain challenging, especially when dealing with peptides. We report an optimized synthetic strategy, where laborious preparation of dimethoxy-nitrobenzyl-tyrosine building blocks was replaced by direct functionalization of amino acid side chains while peptides remained coupled to resin, reducing both preparation time and cost. Our caged peptides were designed to investigate cellular responses mediated by intracellular angiotensin II receptors (iATR) upon interaction with known biased and unbiased ligands. The pathophysiological roles of iATRs remain poorly understood, and we sought to develop ligands to explore this. Initial validation showed that our caged ligands undergo rapid photolysis and produced functionally active peptides upon UV exposure. We also show, for the first time, that different biased ligands (β-arrestin-vs G protein-biased analogues) evoked distinct responses when uncaged in adult rat myofibroblasts. Intracellularly targeted versions of Ang II (unbiased) or G protein-biased analogues (TRV055, TRV056) were more effective than β-arrestin-biased Ang II analogues (SI, TRV026, and TRV27) in inducing collagen secretion, suggesting a divergent role in regulating the fibrotic response.

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Effects of Angiotensin II Receptor Blockers on Ventricular Hypertrophy in Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials

Cited by 9 publications

References 39 publications

A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

The Effect of Angiotensin II Receptor Blockers in Patients with Hypertrophic Cardiomyopathy: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

G Protein-Biased Agonists for Intracellular Angiotensin Receptors Promote Collagen Secretion in Myofibroblasts

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