Cor Vasa 2018, 60(3):e263-e273 | DOI: 10.1016/j.crvasa.2018.02.003

Heart failure and inhibition of renin-angiotensin-aldosteron system

Jiří Vítovec^a,*, Jindřich Špinar^b, Lenka Špinarová^a

^a I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

^b Interní kardiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice Brno, Brno, Česká republika

A historical survey is presented of mortality clinical trials focussed on the inhibition of the renin-angiotensin-aldosterone system on different levels in patients with chronic heart failure. The first study, CONSENSUS, was published in 1987 and showed that the ACE-inhibitor enalapril clearly reduced mortality in severe heart failure compared with placebo. This was followed by studies with beta blockers, angiotensin II type 1 receptor blockers, blockers of mineralocorticoid receptors, and direct renin inhibitors.
A recent study, PARADIGM, comparing dual inhibitor of neprilysin and angiotensin II receptor (LCZ696) with enalapril, was terminated prematurely for a significant effect of inhibiting neprilysin and valsartan.

Keywords: ACE inhibitors; Aliskiren; Angiotensin receptor blockers; Chronic heart failure; Mineralocorticoid receptor antagonists; Omapatrilat; Sacubitril, valsartan (LCZ696)

Received: January 23, 2018; Accepted: February 5, 2018; Published: June 1, 2018  Show citation