The Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Is Associated with the Recovered Ejection Fraction in Patients with Dilated Cardiomyopathy
Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) have been shown to prevent left ventricular remodeling and improve outcomes of patients with heart failure (HF). This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with rec...
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Veröffentlicht in: | International Heart Journal 2021/07/30, Vol.62(4), pp.801-810 |
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description | Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) have been shown to prevent left ventricular remodeling and improve outcomes of patients with heart failure (HF). This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM).We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM between 2003 and 2014 from the clinical personal record, a national database of the Japanese Ministry of Health, Labour and Welfare. Patients with left ventricular ejection fraction (LVEF) < 40% were included. Eligible patients were divided into two groups according to the use of ACEi/ARB. A propensity score matching analysis was employed. The primary outcome was defined as LVEF ≥ 40% at 3 years of follow-up.Out of 5,955 patients with DCM and LVEF < 40%, propensity score matching yielded 830 pairs. The mean age was 58.8 years, and 1,184 (71.3%) of the patients were male. The primary outcome was observed more frequently in the ACEi/ARB group than in the no ACEi/ARB group (57.0% versus 49.3%; odds ratio 1.36; 95% confidence interval (CI) 1.12-1.65; P = 0.002). Subgroup analysis revealed that the use of ACEi and ARB was associated with recovery of LVEF regardless of atrial fibrillation. The change in LVEF from baseline to 3 years of follow-up was greater in the ACEi-ARB group (14.9% ± 0.6% versus 12.3% ± 0.5%; P = 0.001).The use of ACEi/ARB is associated with HFrecEF in patients with DCM and reduced LVEF. |
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This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM).We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM between 2003 and 2014 from the clinical personal record, a national database of the Japanese Ministry of Health, Labour and Welfare. Patients with left ventricular ejection fraction (LVEF) < 40% were included. Eligible patients were divided into two groups according to the use of ACEi/ARB. A propensity score matching analysis was employed. The primary outcome was defined as LVEF ≥ 40% at 3 years of follow-up.Out of 5,955 patients with DCM and LVEF < 40%, propensity score matching yielded 830 pairs. The mean age was 58.8 years, and 1,184 (71.3%) of the patients were male. The primary outcome was observed more frequently in the ACEi/ARB group than in the no ACEi/ARB group (57.0% versus 49.3%; odds ratio 1.36; 95% confidence interval (CI) 1.12-1.65; P = 0.002). Subgroup analysis revealed that the use of ACEi and ARB was associated with recovery of LVEF regardless of atrial fibrillation. The change in LVEF from baseline to 3 years of follow-up was greater in the ACEi-ARB group (14.9% ± 0.6% versus 12.3% ± 0.5%; P = 0.001).The use of ACEi/ARB is associated with HFrecEF in patients with DCM and reduced LVEF.</description><identifier>ISSN: 1349-2365</identifier><identifier>EISSN: 1349-3299</identifier><identifier>DOI: 10.1536/ihj.20-671</identifier><language>eng</language><publisher>Tokyo: International Heart Journal Association</publisher><subject>Angiotensin ; Angiotensin II ; Angiotensin-converting enzyme inhibitors ; Cardiomyopathy ; Congestive heart failure ; Demography ; Dilated cardiomyopathy ; Diuretics ; Echocardiography ; Ejection fraction ; Enzymes ; Fibrillation ; Heart failure with recovered ejection fraction ; Patients ; Peptidyl-dipeptidase A ; Ventricle</subject><ispartof>International Heart Journal, 2021/07/30, Vol.62(4), pp.801-810</ispartof><rights>2021 by the International Heart Journal Association</rights><rights>Copyright Japan Science and Technology Agency 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-a13a04117531eac67b1336a58fcf155022c111dd32adf31281a0125949be413</citedby><cites>FETCH-LOGICAL-c475t-a13a04117531eac67b1336a58fcf155022c111dd32adf31281a0125949be413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1877,27905,27906</link.rule.ids></links><search><creatorcontrib>Enzan, Nobuyuki</creatorcontrib><creatorcontrib>Matsushima, Shouji</creatorcontrib><creatorcontrib>Ide, Tomomi</creatorcontrib><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Tohyama, Takeshi</creatorcontrib><creatorcontrib>Funakoshi, Kouta</creatorcontrib><creatorcontrib>Higo, Taiki</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><title>The Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Is Associated with the Recovered Ejection Fraction in Patients with Dilated Cardiomyopathy</title><title>International Heart Journal</title><addtitle>Int. Heart J.</addtitle><description>Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) have been shown to prevent left ventricular remodeling and improve outcomes of patients with heart failure (HF). This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM).We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM between 2003 and 2014 from the clinical personal record, a national database of the Japanese Ministry of Health, Labour and Welfare. Patients with left ventricular ejection fraction (LVEF) < 40% were included. Eligible patients were divided into two groups according to the use of ACEi/ARB. A propensity score matching analysis was employed. The primary outcome was defined as LVEF ≥ 40% at 3 years of follow-up.Out of 5,955 patients with DCM and LVEF < 40%, propensity score matching yielded 830 pairs. The mean age was 58.8 years, and 1,184 (71.3%) of the patients were male. The primary outcome was observed more frequently in the ACEi/ARB group than in the no ACEi/ARB group (57.0% versus 49.3%; odds ratio 1.36; 95% confidence interval (CI) 1.12-1.65; P = 0.002). Subgroup analysis revealed that the use of ACEi and ARB was associated with recovery of LVEF regardless of atrial fibrillation. The change in LVEF from baseline to 3 years of follow-up was greater in the ACEi-ARB group (14.9% ± 0.6% versus 12.3% ± 0.5%; P = 0.001).The use of ACEi/ARB is associated with HFrecEF in patients with DCM and reduced LVEF.</description><subject>Angiotensin</subject><subject>Angiotensin II</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Cardiomyopathy</subject><subject>Congestive heart failure</subject><subject>Demography</subject><subject>Dilated cardiomyopathy</subject><subject>Diuretics</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Enzymes</subject><subject>Fibrillation</subject><subject>Heart failure with recovered ejection fraction</subject><subject>Patients</subject><subject>Peptidyl-dipeptidase A</subject><subject>Ventricle</subject><issn>1349-2365</issn><issn>1349-3299</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpNkd1O3DAQhSNUJLbADU9gqXeVAh47Tshdt8vSRkIC8XNteZ3JxumuvbVNq_BYfUIMQate2B55vnNG9smyM6DnIHh5YfrhnNG8rOAgmwEv6pyzuv70UTNeiqPscwgDpQUIWs2yf489kqeAxHVkbtfGRbTB2Hzh7B_00dg1WdqXcYuksb1Zmeh8IM7_z5KmIfeocZd65PvG6V-YmCaQeQhOGxWxJX9N7ElMoxLoknG6Wg6oo3GWXHs1FcnqTkWDNoZJcGU27-qF8q1x29HtVOzHk-ywU5uApx_ncfZwvXxc_Mxvbn80i_lNrotKxFwBV-mVUAkOqHRZrYDzUonLTncgBGVMA0DbcqbajgO7BEWBibqoV1gAP86-TK47734_Y4hycM_epoGSCVGlRWueqK8Tpb0LwWMnd95slR8lUPmWiEyJSEZlSiTB3yZ4CFGtcY-q9M96g-9oyWTxtk2SfUv3yku0_BWh05hA</recordid><startdate>20210730</startdate><enddate>20210730</enddate><creator>Enzan, Nobuyuki</creator><creator>Matsushima, Shouji</creator><creator>Ide, Tomomi</creator><creator>Kaku, Hidetaka</creator><creator>Tohyama, Takeshi</creator><creator>Funakoshi, Kouta</creator><creator>Higo, Taiki</creator><creator>Tsutsui, Hiroyuki</creator><general>International Heart Journal Association</general><general>Japan Science and Technology Agency</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope></search><sort><creationdate>20210730</creationdate><title>The Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Is Associated with the Recovered Ejection Fraction in Patients with Dilated Cardiomyopathy</title><author>Enzan, Nobuyuki ; Matsushima, Shouji ; Ide, Tomomi ; Kaku, Hidetaka ; Tohyama, Takeshi ; Funakoshi, Kouta ; Higo, Taiki ; Tsutsui, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-a13a04117531eac67b1336a58fcf155022c111dd32adf31281a0125949be413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angiotensin</topic><topic>Angiotensin II</topic><topic>Angiotensin-converting enzyme inhibitors</topic><topic>Cardiomyopathy</topic><topic>Congestive heart failure</topic><topic>Demography</topic><topic>Dilated cardiomyopathy</topic><topic>Diuretics</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Enzymes</topic><topic>Fibrillation</topic><topic>Heart failure with recovered ejection fraction</topic><topic>Patients</topic><topic>Peptidyl-dipeptidase A</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Enzan, Nobuyuki</creatorcontrib><creatorcontrib>Matsushima, Shouji</creatorcontrib><creatorcontrib>Ide, Tomomi</creatorcontrib><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Tohyama, Takeshi</creatorcontrib><creatorcontrib>Funakoshi, Kouta</creatorcontrib><creatorcontrib>Higo, Taiki</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>International Heart Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Enzan, Nobuyuki</au><au>Matsushima, Shouji</au><au>Ide, Tomomi</au><au>Kaku, Hidetaka</au><au>Tohyama, Takeshi</au><au>Funakoshi, Kouta</au><au>Higo, Taiki</au><au>Tsutsui, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Is Associated with the Recovered Ejection Fraction in Patients with Dilated Cardiomyopathy</atitle><jtitle>International Heart Journal</jtitle><addtitle>Int. Heart J.</addtitle><date>2021-07-30</date><risdate>2021</risdate><volume>62</volume><issue>4</issue><spage>801</spage><epage>810</epage><pages>801-810</pages><artnum>20-671</artnum><issn>1349-2365</issn><eissn>1349-3299</eissn><abstract>Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) have been shown to prevent left ventricular remodeling and improve outcomes of patients with heart failure (HF). This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM).We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM between 2003 and 2014 from the clinical personal record, a national database of the Japanese Ministry of Health, Labour and Welfare. Patients with left ventricular ejection fraction (LVEF) < 40% were included. Eligible patients were divided into two groups according to the use of ACEi/ARB. A propensity score matching analysis was employed. The primary outcome was defined as LVEF ≥ 40% at 3 years of follow-up.Out of 5,955 patients with DCM and LVEF < 40%, propensity score matching yielded 830 pairs. The mean age was 58.8 years, and 1,184 (71.3%) of the patients were male. The primary outcome was observed more frequently in the ACEi/ARB group than in the no ACEi/ARB group (57.0% versus 49.3%; odds ratio 1.36; 95% confidence interval (CI) 1.12-1.65; P = 0.002). Subgroup analysis revealed that the use of ACEi and ARB was associated with recovery of LVEF regardless of atrial fibrillation. The change in LVEF from baseline to 3 years of follow-up was greater in the ACEi-ARB group (14.9% ± 0.6% versus 12.3% ± 0.5%; P = 0.001).The use of ACEi/ARB is associated with HFrecEF in patients with DCM and reduced LVEF.</abstract><cop>Tokyo</cop><pub>International Heart Journal Association</pub><doi>10.1536/ihj.20-671</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Angiotensin Angiotensin II Angiotensin-converting enzyme inhibitors Cardiomyopathy Congestive heart failure Demography Dilated cardiomyopathy Diuretics Echocardiography Ejection fraction Enzymes Fibrillation Heart failure with recovered ejection fraction Patients Peptidyl-dipeptidase A Ventricle |
title | The Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Is Associated with the Recovered Ejection Fraction in Patients with Dilated Cardiomyopathy |
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