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Losartan in the Therapy of Heart Failure Patients

Department of Hospital Therapy State Medical University Zaporozhye, Ukraine
For reprint information contact: Alexander E Berezin, MD Tel: 380 612 72 9607 Fax: 380 612 12 3777 email: megacat{at}mail.ru Department of Hospital Therapy, State Medical University, Chujkow Street, Box 6323, Zaporozhye UA-69121, Ukraine.

The effects of losartan on myocardial remodeling and neurohumoral status were studied in 240 patients with congestive heart failure. The patients were randomized into 3 groups of 80 subjects. Each group continued to receive conventional therapy including the angiotensin-converting enzyme inhibitor enalapril. Group 1 was also given a placebo, groups 2 and 3 had losartan in doses of 25 mg and 50 mg daily, respectively. The course of treatment was 48 weeks. Cardiac function was assessed by B-mode and Doppler echocardiography. Plasma neurohormone levels were determined by radioimmunoassay. Losartan in a dose of 50 mg daily gave the best improvement in cardiac function and the most marked reduction in plasma levels of renin, angiotensin II, aldosterone, atrial natriuretic peptide, endothelin-1, and norepinephrine levels than the lower dose of losartan or placebo. The fall in cortisol and serotonin levels was similar in each group. These data demonstrate the dose-dependent effects of losartan and clarify its role in the treatment of congestive heart failure.