Effects of the AT(1)-receptor antagonist eprosartan on the progression of left ventricular dysfunction in dogs with heart failure

1 We examined the effects of eprosartan, an AT, receptor antagonist, on the progression of left ventricular (LV) dysfunction and remodelling in dogs with heart failure (HF) produced by intracoronary microembolizations (LV ejection fraction, EF 30 to 40%). 2 Dogs were randomized to 3 months of oral therapy with low-dose eprosartan (600 mg once daily, n = 8), high-dose eprosartan (1200 mg once daily, n = 8), or placebo (n = 8). 3 In the placebo group, LV end-diastolic (EDV) and end-systolic (ESV) volumes increased after 3 months (68 +/- 7 vs 82 +/- 9 ml, P < 0.004, 43 +/- 1 vs 58 +/- 7 ml, P < 0.003, respectively), and EF decreased (37 +/- 1 vs 29 +/- 1 %, P < 0.001). In dogs treated with low-dose eprosartan, EF, EDV, and ESV remained unchanged over the course of therapy, whereas in dogs treated with high-dose eprosartan, EF increased (38 +/- 1 vs 42 +/- 1 %, P < 0.004) and ESV decreased (41 +/- 1 vs 37 +/- 1 ml, P<0.006), Eprosartan also decreased interstitial fibrosis and cardiomyocyte hypertrophy. 4 We conclude that eprosartan prevents progressive LV dysfunction and attenuates progressive LV remodelling in dogs with moderate HF and may be useful in treating patients with chronic HF.