Beneficial effects of 1-year captopril therapy in children with chronic aortic regurgitation who have no symptoms

• Published in: The American heart journal Vol. 135; no. 4; pp. 598 - 603
• Main Authors: Alehan, Dursun, Özkutlu, Süheyla
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-04-1998; Elsevier
• Subjects: Administration, Oral; Adolescent; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - drug therapy; Aortic Valve Insufficiency - physiopathology; Biological and medical sciences; Captopril - administration & dosage; Captopril - therapeutic use; Cardiovascular system; Child; Chronic Disease; Dose-Response Relationship, Drug; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Heart Rate - drug effects; Humans; Male; Medical sciences; Miscellaneous; Myocardial Contraction - drug effects; Pharmacology. Drug treatments; Prospective Studies; Radiography, Thoracic; Stroke Volume - drug effects; Treatment Outcome; Tropical medicine; Sonography; Human; Echocardiography; Captopril; Cardiovascular disease; Asymptomatic; Aortic regurgitation; Long term; Left ventricle; Chemotherapy; Treatment; Cardiac valvular disease; Mechanism of action; Child; Aortic valve; ACE inhibitor
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(98)70273-X

Objective This prospective study was performed to assess the effects of 1 year of angiotensin-converting enzyme inhibition with captopril in 20 children (mean age 14.3 ± 2.3 years) with asymptomatic chronic aortic regurgitation.
Methods and Results At 12 months patients receiving captopril had a significant reduction in left ventricular end-diastolic and end-systolic dimensions (57 ± 9.3 vs 51 ± 9.5 mm,
p < 0.001; 35.4 ± 6.1 vs 32 ± 6.8 mm,
p < 0.001), end-diastolic and end-systolic volume indexes (111 ± 36 vs 94 ± 29 ml/m
2,
p < 0.001; 35 ± 13 vs 30 ± 12 ml/m
2,
p < 0.001, respectively), and mass index (138 ± 37 vs 109 ± 32 gm/m
2,
p < 0.0001) determined by two-dimensional echocardiography. Meridian (
p < 0.01) and circumferential (
p < 0.0001) wall stresses also decreased significantly with therapy. Significant reduction (27.8%,
p < 0.0001) was achieved in regurgitant fraction with captopril.
Conclusions These data show that the long-term therapy with angiotensin-converting enzyme inhibitors is able to reverse left ventricular dilation and hypertrophy and suggest that such therapy has the potential to favorably influence the natural history of the disease in children. (Am Heart J 1998;135:598-603.)