PMID- 10883943
OWN - NLM
STAT- MEDLINE
DCOM- 20001107
LR  - 20161124
IS  - 1524-6094 (Print)
IS  - 1524-6094 (Linking)
VI  - 9
IP  - 5
DP  - 2000 Jun
TI  - Reversal of heart failure remodeling in women.
PG  - 513-9
AB  - Epidemiological studies suggest that women with heart failure differ from men 
      with heart failure in that their survival is better. Therapeutic trials have not 
      clearly demonstrated a survival benefit for women. This study was to determine 
      the tolerance for high doses of angiotensin-converting enzyme (ACE) 
      inhibitor-nitrates in women versus men and to compare their symptomatic response, 
      exercise tolerance, and ventricular functional improvement over 1 year. 
      Eighty-eight sequential patients with heart failure, 54 men and 34 women with 
      left ventricular ejection fraction < or = 35%, were prospectively followed for 1 
      year. For all patients, ACE inhibitor-nitrate therapy was intensified. Each 
      patient had three 6-monthly echocardiograms at baseline, at 6 months, and at 1 
      year, and metabolic stress testing. Patients were 57.3 +/- 12.3 years old, with 
      New York Heart Association (NYHA) class severity 2.6 +/- 1.0. Lisinopril dosages 
      were raised from 14 +/- 14 mg/day to 57 +/- 26 mg/day, isosorbide mononitrate 
      from 15 +/- 27 mg/day to 126 +/- 72 mg/day, and carvedilol (n = 34) to 17 +/- 16 
      mg/day. Women and men were epidemiologically comparable, with similar baseline 
      echocardiographic parameters (left ventricular ejection fraction 19% +/- 7% 
      versus 17% +/- 6%, respectively). Both tolerated up-titration in medical therapy. 
      Final 12-month ejection fractions were equivalent for women and men at 34% +/- 
      17% and 34% +/- 13%, respectively, with similar improvements in left ventricular 
      diameters. At 1 year, women had higher resting heart rates and remained more 
      symptomatic with lower exercise capacity. However, the relative changes in NYHA 
      status and aerobic capacity were similar for women and men. Thus, both women and 
      men tolerated uptitrated ACE inhibitor-nitrate medical therapy, with comparable 
      reversal of heart failure remodeling. Although women continued to be more 
      symptomatic than men, relative improvements in symptomatic status, in exercise 
      capacity, and in hospitalization rate were equivalent.
FAU - Levine, T B
AU  - Levine TB
AD  - Michigan Institute for Heart Failure and Transplant Care, Botsford General 
      Hospital, Farmington Hills 48336, USA.
FAU - Levine, A B
AU  - Levine AB
FAU - Kaminski, P
AU  - Kaminski P
FAU - Stomel, R J
AU  - Stomel RJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Womens Health Gend Based Med
JT  - Journal of women's health & gender-based medicine
JID - 100888719
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Vasodilator Agents)
RN  - E7199S1YWR (Lisinopril)
RN  - IA7306519N (Isosorbide Dinitrate)
RN  - LX1OH63030 (isosorbide-5-mononitrate)
SB  - IM
MH  - Analysis of Variance
MH  - Angiotensin-Converting Enzyme Inhibitors/pharmacology/*therapeutic use
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnostic imaging/*drug therapy
MH  - Humans
MH  - Isosorbide Dinitrate/*analogs & derivatives/pharmacology/*therapeutic use
MH  - Lisinopril/pharmacology/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Treatment Outcome
MH  - Vasodilator Agents/pharmacology/*therapeutic use
MH  - Ventricular Remodeling/*drug effects
EDAT- 2000/07/07 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/07/07 11:00
PHST- 2000/07/07 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/07/07 11:00 [entrez]
AID - 10.1089/15246090050073594 [doi]
PST - ppublish
SO  - J Womens Health Gend Based Med. 2000 Jun;9(5):513-9. doi: 
      10.1089/15246090050073594.