Use of converting enzyme inhibitors in patients with asymptomatic left ventricular dysfunction.
The Studies of Left Ventricular Dysfunction (SOLVD) prevention trial evaluated 4,228 patients with a left ventricular ejection fraction < or = 35% who were not receiving drug therapy for heart failure. Patients were randomized to treatment with enalapril or placebo in a dose of 2.5 to 20 mg/day. Patients randomized to enalapril showed a 37% reduction in the development of heart failure and a 36% reduction in hospitalization for heart failure (p < or = 0.001). However, there was only an 8% reduction in total mortality and a 14% reduction in cardiovascular mortality (p = NS). On the basis of the SOLVD prevention trial, patients with asymptomatic left ventricular dysfunction due to either ischemic or nonischemic cardiomyopathy should be started on treatment with an angiotensin-converting enzyme inhibitor to prevent the development of and hospitalization for heart failure.
Pitt
B
B
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001530:Belgium; D002170:Canada; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D016277:Ventricular Function, Left / Q000187:drug effects*
D000806:Angiotensin-Converting Enzyme Inhibitors