%0 Journal Article
%T C¨¢lculo de resistencia vascular sist¨¦mica por ecocardiograf¨ªa en la insuficiencia card¨ªaca cr¨®nica: una herramienta para optimizar la dosis de IECA y ARA II
%A Florio
%A Luc¨ªa
%A Vignolo
%A Gustavo
%A Centuri¨®n
%A Ra¨²l
%A Pouso
%A Jorge
%J Insuficiencia card£¿-aca
%D 2012
%I Scientific Electronic Library Online
%X background. angiotensin converting enzyme inhibitors and angiotensin receptor blockers improve heart failure prognosis, but many patients are not treated with target doses. objective. our aim was to determine if the echocardiographic measurement of systemic vascular resistance could increase the number of patients treated with optimal doses. material and methods. patients with heart failure due to systolic dysfunction and no contraindications to enalapril/ losart¨¢n were included. the target doses considered were enalapril/losart¨¢n ¡İ 20/25mg/day. patients were randomized to adjusted dose using clinical approach and systemic vascular resistance vs clinical parameters only (groups a and b). in group a if systemic vascular resistance was ¡İ 1200 dynes.sec/cm-5, enalapril dose was increased 25% up to 40mg and then losart¨¢n was added (unless contraindication). the main outcome measures in follow-up were changes in proportion of patients receiving enalapril/losart¨¢n target doses, comparing recruit vs last control in both groups. results. seventy patients (50 males, age 60¡À12 years old, 30 in functional class i, systemic vascular resistance 2033¡À802 dines.seg.cm-5), were included and followed-up for 12.3¡Àmonths. there were no significant basal differences between groups. in group a significant increase was observed in the proportion of patients receiving target dose of enalapril/losart¨¢n (50% recruit vs 64% last control, p < 0.01). in group b a significant decrease was observed in the same proportion (59% vs 47%, p <0.05). conclusion. more patients with heart failure received target doses of enalapril/losart¨¢n, when echocardiographic measurement of systemic vascular resistance was used.
%K heart failure
%K systemic vascular resistance
%K echocardiography
%K converting enzyme inhibitors.
%U http://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S1852-38622012000100002&lng=en&nrm=iso&tlng=en