Effects of long-term enalapril therapy on left ventricular diastolic properties in patients with depressed ejection fraction

Abstract

Background. The aim of the present study was to analyze the changes in left ventricular diastolic function that occur in patients with chronic severe left ventricular systolic dysfunction in the absence or presence of prolonged therapy with an angiotensin converting enzyme inhibitor. Methods and Results. Left ventricular function data (cineangiography plus Millar, framc-by-frame analysis) and right ventricular volumes (radionuclide angiography) were obtained at baseline and after an average follow-up of 12.4 months in 42 patients with a left ventricular ejection fraction of 35% or less. After baseline measurements, the patients were randomized to placebo (n=16) or enalapril (10 mg BID, n=26). In the placebo group, the changes in left ventricular function were characterized by increases in end-diastolic (159±43 to 170±44 mL/m2) and end-systolic (119±38 to 128±49 mL/m2) volumes accompanied by a downward and right ward shift of the diastolic pressure-volume relation. In contrast, decreases in end-diastolic (166±43 to 156±47 mL/m2) and end-systolic (125±43 to 111±42 mL/m2) volumes accompanied by a slight upward and leftward shift of the diastolic pressure-volume relation were noted in the enalapril group. These changes in left ventricular volumes were significantly different between groups (both P