title: [The effects of pharmacological treatment in asymptomatic left ventricular dysfunction].
abstract: It is clearly settled that the management of overt heart failure offers poor prognostic impact due to the advanced setting of the disease. Relief of symptoms, objective benefits, as testified by short-term hemodynamic improvements, are as a matter of fact not reliable prognostic markers. Myocardial dysfunction starts early in the natural history of many cardiac diseases, and runs through the steps of progressive wall remodeling, witnessed by quantitative and qualitative changes in cells, interstitium and connective tissue. Experimental studies offered keys to interventions modulated to oppose the pathophysiological changes present in early myocardial dysfunction. At present, medical therapy has made great strides in testing early myocardial dysfunction. Angiotensin-converting enzyme inhibitors, which retard ventricular dilatation and thus may lower myocardial oxygen consumption requirements seem to offer a unique prognostic profile. Preliminary pilot studies on them and some of many large-scale multicentre trials still in progress reached evidence that this class of drugs is by this time a cornerstone of medical therapy, useful to lower cardiac events-rate in patients with heart failure.
authors.affiliation: Dipartimento di Medicina Interna, Università degli Studi, Genova.
authors.forename: S
authors.initials: S
authors.lastname: Caponnetto
authors.forename: U
authors.initials: U
authors.lastname: Martini
authors.forename: C
authors.initials: C
authors.lastname: Brunelli
authors.forename: M
authors.initials: M
authors.lastname: Iannetti
authors.forename: M A
authors.initials: MA
authors.lastname: Masperone
authors.forename: C
authors.initials: C
authors.lastname: Pastorini
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects / Q000502:physiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D004341:Drug Evaluation; D004353:Drug Evaluation, Preclinical; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
vernacular_title: Effetti del trattamento farmacologico nella disfunzione ventricolare sinistra asintomatica.