American Journal of Cardiology
Volume 104, Issue 11 , Pages 1484-1489 , 1 December 2009

Left Ventricular Mass and Volume With Telmisartan, Ramipril, or Combination in Patients With Previous Atherosclerotic Events or With Diabetes Mellitus (from the ONgoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial [ONTARGET])

  • Brett R. Cowan, BE, MBChB

      Affiliations

    • Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
  • ,
  • Alistair A. Young, PhD

      Affiliations

    • Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
    • Corresponding Author InformationCorresponding author: Tel: 64-9-3737-599, ext 86115; fax: 64-9-3737-484
  • ,
  • Craig Anderson, MBBS, PhD

      Affiliations

    • Clinical Trials Research Unit, School of Population Health, University of Auckland, Auckland, New Zealand
    • The George Institute for International Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
  • ,
  • Robert N. Doughty, MD

      Affiliations

    • Department of Medicine, University of Auckland, Auckland, New Zealand
  • ,
  • Rungroj Krittayaphong, MD

      Affiliations

    • Division of Cardiology, Department of Medicine, Siriraj Hospital, Bankok, Thailand
  • ,
  • Eva Lonn, MD, MSc

      Affiliations

    • Department of Medicine, Division of Cardiology and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Thomas H. Marwick, MBBS, PhD

      Affiliations

    • Department of Medicine, University of Queensland, Brisbane, Australia
  • ,
  • Chris M. Reid, BA, DipEd, MSc, PhD

      Affiliations

    • Baker IDI Heart and Diabetes Institute, Melbourne, Australia
    • CCRE Therapeutics, Monash University, Melbourne, Australia
  • ,
  • John E. Sanderson, MD

      Affiliations

    • Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
    • Department of Cardiovascular Medicine, University of Birmingham, Birmingham, United Kingdom
  • ,
  • Roland E. Schmieder, MD

      Affiliations

    • Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
  • ,
  • Koon Teo, MB, PhD

      Affiliations

    • Department of Medicine, Division of Cardiology and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Angela K. Wadham, BA

      Affiliations

    • Clinical Trials Research Unit, School of Population Health, University of Auckland, Auckland, New Zealand
  • ,
  • Stephen G. Worthley, MBBS, PhD

      Affiliations

    • Cardiovascular Investigation Unit, Royal Adelaide Hospital, Adelaide, Australia
  • ,
  • Cheuk-Man Yu, MD

      Affiliations

    • Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
  • ,
  • Salim Yusuf, MD

      Affiliations

    • Department of Medicine, Division of Cardiology and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Garry L. Jennings, MD

      Affiliations

    • Baker IDI Heart and Diabetes Institute, Melbourne, Australia
  • ,
  • ONTARGET Investigators

Received 6 May 2009 ,Revised 10 July 2009 ,Accepted 10 July 2009.

References 

  1. Teo K, Yusuf S, Sleight P, Anderson C, Mookadam F, Ramos B, et al. Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND) trials. Am Heart J. 2004;148:52–61
  2. Sleight P. The ONTARGET/TRANSCEND trial programme: baseline data. Acta Diabetol. 2005;42:S50–S56
  3. The HOPE Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on CV events in high-risk patients. N Engl J Med. 2000;342:145–153
  4. Lonn E, Shaikholeslami R, Yi Q, Bosch J, Sullivan B, Tanser P, et al. Effects of ramipril on left ventricular mass and function in cardiovascular patients with controlled blood pressure and with preserved left ventricular ejection fraction (A substudy of the Heart Outcomes Prevention Evaluation (HOPE) Trial). J Am Coll Cardiol. 2004;43:2200–2206
  5. The ONTARGET Investigators. Telmisartan, ramipril or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–1559
  6. Pattynama P, De Roos A, Van der Wall E, Van Voorthuisen A. Evaluation of cardiac function with magnetic resonance imaging. Am Heart J. 1994;128:595–607
  7. Myerson SG, Bellenger NG, Pennell DJ. Assessment of left ventricular mass by cardiovascular magnetic resonance. Hypertension. 2002;39:750–755
  8. Bottini P, Carr A, Prisant L, Flickinger F, Allison J, Gottdiener J. Magnetic resonance imaging compared to echocardiography to assess left ventricular mass in the hypertensive patient. Am J Hypertens. 1995;8:221–228
  9. Pattynama PMT, Lamb HJ, van der Velde EA, van der Wall EE, de Roos A. Left ventricular measurements with cine and spin-echo MR imaging: a study of reproducibility with variance component analysis. Radiology. 1993;187:261–268
  10. Reichek N. Magnetic resonance imaging for assessment of myocardial function. Magn Reson Q. 1991;7:255–274
  11. Fieno D, Jaffe W, Simonetti O, Judd R, Finn J. TrueFISP (Assessment of accuracy for measurement of left ventricular mass in an animal model). J Magn Reson Imaging. 2002;15:526–531
  12. Lorenz C, Walker E, Morgan V, Klein S, Graham T. Normal human right and left ventricular mass, systolic function and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 1999;1:7–21
  13. Tseng W, Liao T, Wang J. Normal systolic and diastolic functions of the left ventricle and left atrium by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 2002;4:443–457
  14. Cowan BR, Young AA, Anderson C, Doughty RN, Krittayaphong R, Lonn E, et al. The cardiac MRI substudy to ongoing telmisartan alone and in combination with ramipril global endpoint trial/telmisartan randomized assessment study in ACE-intolerant subjects with cardiovascular disease: analysis protocol and baseline characteristics. Clin Res Cardiol. 2009;98:421–433
  15. Young A, Cowan B, Thrupp S, Hedley W, Dell'Italia L. Left ventricular mass and volume: fast calculation with guide-point modeling on MR images. Radiology. 2000;216:597–602
  16. White H, Norris R, Brown M, Brandt P, Whitlock R, Wild C. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987;76:44–51
  17. Klingbeil AU, Schneider MP, Martus P, Messereli FH, Schmieder RE. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med. 2003;115:41–46
  18. Schmieder RE, Schlaich MP, Klingbeil AU, Martus P. Update on reversal of left ventricular hypertrophy in essential hypertension (a meta analysis of all randomized double-blind studies until December 1996). Nephrol Dial Transplant. 1998;13:564–569
  19. Matchar DB, McCrory DC, Orlando LA, Patel MR, Patel UD, Patwardhan MB, et al. Systematic review: comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers for treating essential hypertension. Ann Intern Med. 2008;148:16–29
  20. Galzerano D, Tammaro P, Cerciello A, Breglio R, Mallardo M, Lama D, et al. Freehand three-dimensional echocardiographic evaluation of the effect of telmisartan compared with hydrochlorothiazide on left ventricular mass in hypertensive patients with mild-to-moderate hypertension: a multicentre study. J Hum Hypertens. 2004;18:53–59
  21. Mattioli AV, Zennaro M, Bonatti S, Bonetti L, Mattioli G. Regression of left ventricular hypertrophy and improvement of diastolic function in hypertensive patients treated with telmisartan. Int J Cardiol. 2004;97:383–388
  22. Ivanova OV, Fomicheva OA, Sergakova LM, Chernova NA, Rogoza AN, Karpov YA. Angiotensin II receptor blocker telmisartan: effect on blood pressure profile and left ventricular hypertrophy in patients with arterial hypertension. J Int Med Res. 2005;33(suppl 1):21A–29A
  23. Petrovic I, Petrovic D, Vukovic N, Zivanovic B, Dragicevic J, Vasiljevic Z, et al. Ventricular and vascular remodelling effects of the angiotensin II receptor blocker telmisartan and/or the angiotensin-converting enzyme inhibitor ramipril in hypertensive patients. J Int Med Res. 2005;33(suppl 1):39A–49A
  24. Pitt B, Reichek N, Willenbrock R, Zannad F, Phillips RA, Roniker B, et al. Effects of eplerenone, enalapril, and eplerenone/enalapril in patients with essential hypertension and left ventricular hypertrophy: the 4E-Left Ventricular Hypertrophy Study. Circulation. 2003;108:1831–1838
  25. MacMahon S, Sharpe N, Gamble G, Clague A, Mhurchu CN, Clark T, et al. Randomized, placebo-controlled trial of the angiotensin-converting enzyme inhibitor, ramipril, in patients with coronary or other occlusive arterial disease. PART-2 Collaborative Research Group. Prevention of Atherosclerosis with Ramipril. J Am Coll Cardiol. 2000;36:438–443
  26. Jennings G, Wong J. Regression of left ventricular hypertrophy in hypertension: changing patterns with successive meta-analyses. J Hypertens Suppl. 1998;16:S29–S34
  27. Cooper GJS, Young AA, Gamble GD, Occleshaw CJ, Dissanayake AM, Cowan BC, et al. Randomized controlled trial of trientine in type-2 diabetic patients with left ventricular hypertrophy and diastolic dysfunction. Diabetologia. 2009;52:715–722
  28. Cooper GJS, Phillips ARJ, Choong SY, Leonard BL, Crossman DJ, Brunton DH, et al. Regeneration of the heart in diabetes by selective copper chelation. Diabetes. 2004;53:2501–2508

 This work was supported by McMaster University, Hamilton, Ontario, Canada, and Boehringer Ingleheim, Ingleheim, Germany.

PII: S0002-9149(09)01355-1

doi: 10.1016/j.amjcard.2009.07.018

American Journal of Cardiology
Volume 104, Issue 11 , Pages 1484-1489 , 1 December 2009