Safety and efficacy of angiotensin-converting enzyme inhibitors in symptomatic severe aortic stenosis: symptomatic cardiac obstruction–pilot study of enalapril in aortic stenosis (SCOPE-AS)

Chockalingam, Anand; Venkatesan, S.; Subramaniam, T.; Jagannathan, V.; Elangovan, Satheesh; Alagesan, R; Gnanavelu, G; Dorairajan, Smrita; Krishna, Bhavya; Chockalingam, V

doi:10.1016/j.ahj.2003.10.017

Cited by 130 publications

(64 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Adverse reactions resulting from symptomatic hypotension developed in 3 patients who had reduced LV systolic function and an initial systolic BP <100 mm Hg. 10 Another analysis from SEAS showed that renin-angiotensin system inhibition is not associated with increased sudden cardiac death, cardiovascular mortality, or all-cause mortality. We found that low diastolic BP was related to all-cause mortality and heart failure in patients with moderate AS.…”

Section: Bp and Outcome In Other Studiesmentioning

confidence: 99%

Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis

et al. 2016

View full text Add to dashboard Cite

Background: Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis is scarce. We used data from the SEAS trial (Simvastatin Ezetimibe in Aortic Stenosis) to assess what blood pressure (BP) would be optimal. Methods: A total of 1767 patients with asymptomatic aortic stenosis and no manifest atherosclerotic disease were analyzed. Outcomes were all-cause mortality, cardiovascular death, heart failure, stroke, myocardial infarction, and aortic valve replacement. BP was analyzed in Cox models as the cumulative average of serially measured BP and a time-varying covariate. Results: The incidence of all-cause mortality was highest for average follow-up systolic BP ≥160 mm Hg (4.3 per 100 person-years; 95% confidence interval [CI], 3.1–6.0) and lowest for average systolic BP of 120 to 139 mm Hg (2.0 per 100 person-years; 95% CI, 1.6–2.6). In multivariable analysis, all-cause mortality was associated with average systolic BP <120 mm Hg (hazard ratio [HR], 3.4; 95% CI, 1.9–6.1), diastolic BP ≥90 mm Hg (HR, 1.8; 95% CI, 1.1–2.9), and pulse pressure <50 mm Hg (HR, 1.8; 95% CI, 1.1–2.9), with systolic BP of 120 to 139 mm Hg, diastolic BP of 70 to 79 mm Hg, and pulse pressure of 60 to 69 mm Hg taken as reference. Low systolic and diastolic BPs increased risk in patients with moderate aortic stenosis. With a time-varying systolic BP from 130 to 139 mm Hg used as reference, mortality was increased for systolic BP ≥160 mm Hg (HR, 1.7; P =0.033) and BP of 120 to 129 mm Hg (HR, 1.6; P =0.039). Conclusions: Optimal BP seems to be systolic BP of 130 to 139 mm Hg and diastolic BP of 70 to 90 mm Hg in these patients with asymptomatic aortic stenosis and no manifest atherosclerotic disease or diabetes mellitus. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00092677.

show abstract

Section: Bp and Outcome In Other Studiesmentioning

confidence: 99%

Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In patients with symptomatic aortic stenosis who are not candidates for aortic valve replacement, pharmacological therapy is tailored to adjunctive treatments for congestive heart failure, volume overloaded conditions, arrhythmias, and hypertension. 85,86 …”

Section: Surgical Interventionmentioning

confidence: 99%

Spectrum of Calcific Aortic Valve Disease

2005

View full text Add to dashboard Cite

“…It is important to note that the use of ACE inhibitors is contraindicated in the treatment of patients with severe asymptomatic aortic stenosis [2]. However, there are studies that have examined the use of ACE inhibitors to manage symptomatic atherosclerosis, with remarkable clinical improvement in subjects with generally preserved left ventricular function [21]. These studies also propose that the tissue level antiproliferative effects of ACE inhibitors may be responsible for this acute benefit in symptoms and effort tolerance [21].…”

Section: Emerging Experimental Data For the Atherosclerotic Hypothesismentioning

confidence: 99%

“…However, there are studies that have examined the use of ACE inhibitors to manage symptomatic atherosclerosis, with remarkable clinical improvement in subjects with generally preserved left ventricular function [21]. These studies also propose that the tissue level antiproliferative effects of ACE inhibitors may be responsible for this acute benefit in symptoms and effort tolerance [21]. There are also interesting new data concerning the role of vasodilation with nitroprusside, which improves cardiac output by afterload reduction in New York Heart Association (NYHA) class IV patients with critical atherosclerosis and left ventricular dys-function [22].…”

Section: Emerging Experimental Data For the Atherosclerotic Hypothesismentioning

confidence: 99%

Is it time for medical therapy for aortic valve disease?

Rajamannan¹

2004

Expert Review of Cardiovascular Therapy

View full text Add to dashboard Cite

show abstract

Safety and efficacy of angiotensin-converting enzyme inhibitors in symptomatic severe aortic stenosis: symptomatic cardiac obstruction–pilot study of enalapril in aortic stenosis (SCOPE-AS)

Cited by 130 publications

References 24 publications

Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis

Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis

Spectrum of Calcific Aortic Valve Disease

Is it time for medical therapy for aortic valve disease?

Contact Info

Product

Resources

About