Effect of losartan and captopril on congestive heart failure

Objective: To compare the effect of angiotensin Ⅱ antagonist (AngⅡA) losartan with angiotensin converting enzyme inhibitors (ACEI) captopril and the combination of the two agents on congestive heart failure. Methods: Sixty patients with ischemic cardiomyopathy or dilated cardiomyopathy are randomly divided into 3 groups: captopril group, losartan group, combination group. Clinical parameters, including heart function, assessed by NYHA, and LVEF, LVESV, LVEDV, measured by echocardiography, are recorded at the beginning and 1,3,6,12 months after therapy. Results: The parameters after treatment were respectively different from those before. Heart function, LVESV, LVEDV, LVEF of the captopril group or combination group have improved obviously after 1 month therapy compared with those of losartan group. LVEF and LVESV of captopril group show the trend of increase with prolongation of treatment. The parameters of combination group show the tendancy of stable after 3 months. The parameters of losartan group increased significantly in 3 months than before. The change of the three groups have no statistically significant in 3?6?12 month. Conclusion: Both angiotensin Ⅱ antagonist (AngⅡA) and angiotensin coverting enzyme inhibitors(ACEI) can reverse the myocardial remodeling, prevent the progress of heart failure and improve the heart function. They have equal effect on long term treatment of heart failure. But in acute period, ACEI is better than losartan because it can immediately improve the symptom. The combination of two agents hasn't shown the benefit and increase the financial burden of the patients.