Journal article

Use of ACE inhibitors in Fontan: Rational or irrational?

Thomas G Wilson, Ajay J Iyengar, David S Winlaw, Robert G Weintraub, Gavin R Wheaton, Thomas L Gentles, Julian Ayer, Leeanne E Grigg, Robert N Justo, Dorothy J Radford, Andrew Bullock, David S Celermajer, Kim Dalziel, Chris Schilling, Yves d'Udekem



BACKGROUND: 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 ..

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Funding Acknowledgements

The authors thank Murdoch Childrens Research Institute for infrastructure support. The authors also acknowledge Fontan Registry management and research assistants for their invaluable support in the creation and maintenance of the Registry, as well as support in data gathering for this paper and to Belinda Bortone for administrative support. The authors acknowledge support provided to the Murdoch Childrens Research Institute by the Victorian Government's Operational Infrastructure Support Programme.