[Converting enzyme inhibitors and aims of the objectives of the treatment of cardiac failure].
Angiotensin-converting enzyme (ACE) inhibitors were introduced in the treatment of heart failure in 1982. They improve the life comfort of the patients and their capacity for exercise in both moderate and severe heart failure. In moderate heart failure, their effectiveness on exercise performance is about the same as that of digitalis compounds and classical vasodilators, and superior to that of diuretics. The superiority of ACE inhibitors lies in that they improve the prognosis of heart failure, as has been demonstrated in the severe and moderate forms of the disease and, quite recently, in asymptomatic left ventricular dysfunction following myocardial infarction. Their beneficial effects on mortality undoubtedly result from their favourable action on the neurohormonal systems which are activated early in the course of heart failure. Extending the indications of these drugs to asymptomatic patients raises questions concerning optimal dosage, date of initiation and duration of treatment and possible class effect.
Komajda
M
M
Service de cardiologie, CHU Pitié Salpêtrière, Paris.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans
D000806:Angiotensin-Converting Enzyme Inhibitors
Inhibiteurs de l'enzyme de conversion et objectifs du traitement de l'insuffisance cardiaque.