Limitation of left ventricular hypertrophy and dysfunction by ACE inhibition after anterior Q-wave myocardial infarction

• Published in: Cardiology Vol. 89; no. 4; p. 283
• Main Authors: Jugdutt, B I, Humen, D P
• Format: Journal Article
• Language: English
• Published: Switzerland 01-05-1998
• Subjects: Analysis of Variance; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Captopril - therapeutic use; Chi-Square Distribution; Double-Blind Method; Echocardiography; Female; Humans; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - drug therapy; Hypertrophy, Left Ventricular - etiology; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Nitroglycerin - therapeutic use; Prospective Studies; Ultrasonography, Doppler; Vasodilator Agents - therapeutic use; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - etiology
• ISSN: 0008-6312
• DOI: 10.1159/000006801

To determine whether limitation of left ventricular (LV) hypertrophy with angiotensin-converting enzyme inhibition after myocardial infarction (MI) is associated with improved systolic and diastolic function, quantitative two-dimensional echocardiograms and Doppler of 40 patients, who were randomized on day 3 after a first Q-wave anterior MI to receive therapy with captopril (12.5 mg t.i.d.) or placebo for 6 weeks, were analyzed for LV volumes (Simpson's rule) and mass (3D reconstruction), remodeling parameters and peak early (E) and late (A) transmitral flow velocities and deceleration times (DT) at 3 days, 6 weeks, 6 months and 1 year. Compared to placebo over 1 year, captopril limited (p < 0.001) the increase in diastolic volume and mass, increased LV ejection fraction and diastolic E/A ratio, and decreased DT, the frequency of E and A reversal, infarct expansion and aneurysm frequency but volume/ mass ratio was unchanged. Captopril over the first 6 weeks after a first Q-wave anterior MI limited LV remodeling and hypertrophy and improved both systolic and diastolic function up to 1 year.