Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/4944
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dc.contributor.authorIyengar, A. J.en
dc.contributor.authorAyer, J.en
dc.contributor.authorGrigg, L. E.en
dc.contributor.authorJusto, R. N.en
dc.contributor.authorRadford, D. J.en
dc.contributor.authorBullock, A.en
dc.contributor.authorCelermajer, D. S.en
dc.contributor.authorDalziel, K.en
dc.contributor.authorSchilling, C.en
dc.contributor.authorD'Udekem, Y.en
dc.contributor.authorGentles, T. L.en
dc.contributor.authorWeintraub, R. G.en
dc.contributor.authorWilson, T. G.en
dc.contributor.authorWinlaw, D. S.en
dc.contributor.authorWheaton, G. R.en
dc.date.accessioned2022-11-07T23:57:53Z-
dc.date.available2022-11-07T23:57:53Z-
dc.date.issued2016en
dc.identifier.citation210 , 2016, p. 95-99en
dc.identifier.otherRISen
dc.identifier.urihttp://dora.health.qld.gov.au/qldresearchjspui/handle/1/4944-
dc.description.abstractBackground Despite a lack of evidence supporting the use of angiotensin-converting enzyme (ACE) inhibitors in patients with a Fontan circulation, their use is frequent. We decided to identify the rationale for ACE inhibitor therapy in patients within the Australia and New Zealand Fontan Registry. Methods All patients in the Registry taking an ACE inhibitor at last follow up were identified, and a review of medical records was undertaken to determine the rationale for treatment initiation and reasons for treatment continuation or dose increase. Results In 2015, 36% of the surviving patients in the Registry (462/1268) were taking an ACE inhibitor. Indications for initiation of therapy were ventricular systolic or diastolic dysfunction (29%), atrioventricular valve regurgitation (19%), preservation of normal ventricular function (7%), prolonged effusions at Fontan (6%), hypertension (6%), other (6%) and unknown (2%). No indication was stated in the remaining patients (25%). Those with hypoplastic left heart syndrome were more likely to be on an ACE inhibitor than those with an alternative primary morphology (70% vs 32%; p < 0.001). Only 36% of the patients treated with an ACE inhibitor at last follow up (166/462) had an indication that would generally justify treatment in a two-ventricle circulation. Conclusion It is likely that the use of ACE inhibitors in patients with a Fontan circulation is excessive within our region. The coordination of prospective, multicentre studies and initiatives such as the Australia and New Zealand Fontan Registry will facilitate further investigations to guide treatment decisions in the growing Fontan population.L6101239562016-05-09 <br />2020-10-07 <br />en
dc.language.isoenen
dc.relation.ispartofInternational Journal of Cardiologyen
dc.titleUse of ACE inhibitors in Fontan: Rational or irrational?en
dc.typeArticleen
dc.identifier.doi10.1016/j.ijcard.2016.02.089en
dc.subject.keywordsmedical record reviewen
dc.subject.keywordsmigraineen
dc.subject.keywordsmitral valve regurgitationen
dc.subject.keywordspleura effusionen
dc.subject.keywordspriority journalen
dc.subject.keywordsprotein losing gastroenteropathyen
dc.subject.keywordssystolic dysfunctionen
dc.subject.keywordstricuspid valve regurgitationen
dc.subject.keywordscandesartancaptoprilen
dc.subject.keywordscilazaprilen
dc.subject.keywordsdipeptidyl carboxypeptidase inhibitoren
dc.subject.keywordsenalaprilen
dc.subject.keywordsirbesartanen
dc.subject.keywordslisinoprilen
dc.subject.keywordsperindoprilen
dc.subject.keywordsquinaprilen
dc.subject.keywordsramiprilen
dc.subject.keywordstrandolaprilen
dc.subject.keywordsadolescenten
dc.subject.keywordsadulten
dc.subject.keywordsarticleen
dc.subject.keywordschilden
dc.subject.keywordscontrolled studyen
dc.subject.keywordscost benefit analysisen
dc.subject.keywordsdiastolic dysfunctionen
dc.subject.keywordsdrug costen
dc.subject.keywordsdrug indicationen
dc.subject.keywordsfemaleen
dc.subject.keywordsfollow upen
dc.subject.keywordsFontan procedureen
dc.subject.keywordshumanen
dc.subject.keywordshypertensionen
dc.subject.keywordskidney diseaseen
dc.subject.keywordsmajor clinical studyen
dc.subject.keywordsmaleen
dc.relation.urlhttps://www.embase.com/search/results?subaction=viewrecord&id=L610123956&from=exporthttp://dx.doi.org/10.1016/j.ijcard.2016.02.089 |en
dc.identifier.risid2050en
dc.description.pages95-99en
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeArticle-
item.languageiso639-1en-
Appears in Sites:Children's Health Queensland Publications
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