Effect of ramipril on left ventricular mass in normotensive hemodialysis patients.

Abstract

BACKGROUND:

Normotensive hemodialysis patients may still have left ventricular hypertrophy in the absence of significant pressure or volume overload. We examined the hypothesis that treatment with an angiotensin-converting enzyme inhibitor could be beneficial in the reversal of left ventricular hypertrophy in these patients.

METHODS:

Forty-six normotensive patients with end-stage renal disease on regular hemodialysis therapy were randomly assigned to administration of ramipril, 2.5 mg 3 times/wk, or placebo for 1 year. Left ventricular mass index and parameters of cardiovascular structure and function were evaluated noninvasively by means of echocardiography and arterial tonometry at baseline, 6 and 12 months after treatment, and 1 month after washout.

RESULTS:

In the ramipril group, blood pressure decreased significantly at 6 and 12 months after treatment. There were no significant within-group or between-group differences in left ventricular mass index at entry, 6 and 12 months after treatment, and 1 month after washout. There were no significant differences in left atrial dimension, left ventricular size and wall thickness, left ventricular ejection fraction, aortic dimension, intima-media thickness, elastic modulus and augmentation index of the common carotid artery, and aortic pulse wave velocity between the ramipril and placebo groups at entry, 6 and 12 months after treatment, and 1 month after washout.

CONCLUSION:

A 12-month treatment with ramipril did not cause significant regression of left ventricular hypertrophy in normotensive hemodialysis patients. Results may suggest that the renin-angiotensin system has little role in the pathogenesis of mild left ventricular hypertrophy in these patients.

• Authors: Wen-Chung Yu, Yao-Ping Lin, I-Feng Lin, Shao-Yuan Chuang, Chen-Huan Chen
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 47 Issue 3 Pg. 478-84 (Mar 2006) ISSN: 1523-6838 [Electronic] United States
• PMID: 16490627 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Ramipril

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Double-Blind Method
• Female
• Heart Ventricles (drug effects)
• Humans
• Hypertrophy, Left Ventricular (etiology, prevention & control)
• Male
• Middle Aged
• Ramipril (therapeutic use)
• Renal Dialysis (adverse effects)