The effect of captopril on thallium 201 myocardial perfusion in systemic sclerosis.
In systemic sclerosis, abnormalities of myocardial perfusion are common and may be caused by a disturbance of the coronary microcirculation. We evaluated the long-term effect of captopril (75 to 150 mg per day) on thallium 201 myocardial perfusion in 12 normotensive patients with systemic sclerosis. Captopril significantly decreased the mean (+/- SD) number of segments with thallium 201 myocardial perfusion defects (6.5 +/- 1.9 at baseline and 4.4 +/- 2.7 after 1 year of treatment with captopril; p less than 0.02) and increased the mean global thallium score (9.6 +/- 1.7 at baseline and 11.4 +/- 2.1 after captopril; p less than 0.05). In a control group of eight normotensive patients with systemic sclerosis who did not receive captopril, no significant modification in thallium results occurred. Side effects with captopril included hypotension (six patients), taste disturbances (one patient), and skin rash (one patient). These side effects subsided when the dosage was reduced. These findings demonstrate that captopril improves thallium 201 myocardial perfusion in patients with systemic sclerosis and may therefore have a beneficial effect on scleroderma myocardial disease.
Department of Rheumatology, René Descartes University, School of Medicine, Hôpital Cochin, Paris, France.
A
A
Kahan
J Y
JY
Devaux
B
B
Amor
C J
CJ
Menkès
S
S
Weber
A
A
Venot
G
G
Strauch
D000328:Adult; D002216:Captopril / Q000009:adverse effects / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D003326:Coronary Circulation / Q000187:drug effects; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D011877:Radionuclide Imaging; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents / Q000627:therapeutic use
D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D002216:Captopril