PMID- 10363743
OWN - NLM
STAT- MEDLINE
DCOM- 19990617
LR  - 20190905
IS  - 0954-6820 (Print)
IS  - 0954-6820 (Linking)
VI  - 245
IP  - 5
DP  - 1999 May
TI  - The circulating renin-angiotensin system during treatment with metoprolol or 
      captopril in patients with heart failure due to non-ischaemic dilated 
      cardiomyopathy.
PG  - 435-43
AB  - OBJECTIVE: To investigate the effects of beta-blocker (metoprolol) or 
      angiotensin-converting enzyme inhibitor (captopril) treatment on neurohormonal 
      function in a randomized prospective study on patients with heart failure due to 
      dilated cardiomyopathy. PATIENTS: Fifty-four patients (42 men and 12 women, mean 
      age 50 years) were studied. There were three patients in NYHA (New York Heart 
      Association) functional class I, 32 patients in class II and 19 patients in class 
      III. METHODS: Measurements of plasma renin activity (PRA). plasma angiotensin II 
      (A II) concentration and plasma atrial natriuretic peptide (ANP) concentration 
      were made at rest and also in a subgroup (n = 32) during exercise. The urinary 
      excretion of aldosterone was also determined. Investigations were performed at 
      baseline, and after 3 and 6 months. Therapy was then stopped and the patients 
      were re-investigated 1 month thereafter. RESULTS: The mean level of PRA was 
      normal at baseline, reduced during therapy with metoprolol, and increased during 
      therapy with captopril. The mean plasma concentration of A II was reduced during 
      exercise and there was a trend towards a reduction even at rest in the metoprolol 
      group, but not in the captopril group. The urinary excretion of aldosterone 
      decreased in both groups. The mean plasma concentration of ANP was elevated at 
      baseline and declined during exercise in the metoprolol group. CONCLUSION: In 
      patients with dilated cardiomyopathy and only a partly activated 
      renin-angiotensin system, both metoprolol and captopril reduced urinary excretion 
      of aldosterone. Furthermore, metoprolol suppressed the exercise-induced increase 
      in ANP, suggesting a favourable effect on ventricular performance.
FAU - Jansson, K
AU  - Jansson K
AD  - Linkoping Heart Centre, Linkoping University Hospital, Sweden.
FAU - Dahlstrom, U
AU  - Dahlstrom U
FAU - Karlberg, B E
AU  - Karlberg BE
FAU - Karlsson, E
AU  - Karlsson E
FAU - Nylander, E
AU  - Nylander E
FAU - Nyquist, O
AU  - Nyquist O
FAU - Karlberg, K E
AU  - Karlberg KE
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 11128-99-7 (Angiotensin II)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - 9G64RSX1XD (Captopril)
RN  - EC 3.4.23.15 (Renin)
RN  - GEB06NHM23 (Metoprolol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Angiotensin II/*blood
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Atrial Natriuretic Factor/*blood
MH  - Captopril/*therapeutic use
MH  - Cardiomyopathy, Dilated/*complications
MH  - Exercise
MH  - Female
MH  - Heart Failure/*blood/*drug therapy/etiology
MH  - Humans
MH  - Male
MH  - Metoprolol/*therapeutic use
MH  - Middle Aged
MH  - Renin/*blood
MH  - Rest
EDAT- 1999/06/11 00:00
MHDA- 1999/06/11 00:01
CRDT- 1999/06/11 00:00
PHST- 1999/06/11 00:00 [pubmed]
PHST- 1999/06/11 00:01 [medline]
PHST- 1999/06/11 00:00 [entrez]
AID - 10.1046/j.1365-2796.1999.00458.x [doi]
PST - ppublish
SO  - J Intern Med. 1999 May;245(5):435-43. doi: 10.1046/j.1365-2796.1999.00458.x.