Effects of fosinopril and metoprolol on cardiac remodeling and plasma levels of neurohormones in heart failure patients

Objective To explore the effects of fosinopril and metoprolol on cardiac remodeling and the plasma levels of angiotensin II(AngⅡ),endothelin-1(ET-1) and nitric oxide(NO) in patients with congestive heart failure(CHF).Methods A total of 80 patients with CHF were divided into 3 groups,fosinopril(20 mg/d),metoprolol(from 6.25 mg,twice a day to 100 mg,twice a day or the highest tolerant dose) and combination groups(as in single use),and all were treated for 12 months.Electrocardiography including ejection fraction(EF)and left ventricular end diastolic diameter(LVEDD)was carried out,and plasma levels of the 3 neurohormones were detected with conventional methods at admission and 12 months after the treatment.(Results Plasma) levels of AngⅡ,ET-1 and NO were decreased significantly in all groups.No significant difference was seen between fosinopril and metoprolol groups,but the plasma levels was decreased remarkably(P0.01) compared to fosinopril group but not metoprolol group;LVEF and LVEDD of all groups were improved and especially in combination group.Conclusion Fosinopril and metoprolol can improve cardiac function,reverse cardiac remodeling and decrease the plasma levels of AngⅡ,ET-1 and NO.Thus there may exist a synergistic relation between sympathetic nervous system and renin-angiotensin-aldosterone system.