Effects of early use of captopril on haemodynamics and short-term ventricular remodelling in acute anterior myocardial infarction.
To determine whether ventricular short-term enlargement following acute myocardial infarction is related to increased left filling pressures and whether early treatment with captopril alters this process we studied 68 patients with a first acute myocardial infarction. Forty patients with a pulmonary capillary pressure equal or above 17 mmHg were randomized to treatment with conventional therapy plus captopril (n 20) or placebo (n 20), in a double blind fashion. The remaining 28 patients (non-dysfunction group) were treated conventionally. During the first 72 h, afterload showed a prompt decrease in the captopril group as compared to placebo. Changes from baseline to 14 days in end-diastolic and end-systolic left ventricular volume indexes determined by radionuclide ventriculography were: non-dysfunction, 85.6 (+/- 21) vs 88 (+/- 20) and 44 (+/- 17) vs 44 (+/- 17) ml.m-2; captopril (n 20), 96.6 (+/- 18) vs 99 (+/- 19) and 66 (+/- 22) vs 65 (+/- 22) ml.m-2; placebo (n 20), 96 (+/- 25) vs 113 (+/- 19) (P < 0.001) and 63 (+/- 18) vs 74 (+/- 22) ml.m-2 (P < 0.01). This study indicates that short-term ventricular enlargement is related to the degree of ventricular dysfunction and that captopril may improve this process.
Galcera-Tomas
J
J
Coronary Care Unit, University Hospital Virgen de la Arrixaca, Murcia, Spain.
Nuño de la Rosa
J A
JA
Torres-Martinez
G
G
Rodriguez-Garcia
P
P
Castillo-Soria
F J
FJ
Canton-Martinez
A
A
Campos-Peris
J V
JV
Pico-Aracil
F
F
Ruiz-Ros
J A
JA
Ruiperez-Abizanda
J A
JA
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002216:Captopril / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D006352:Heart Ventricles / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D002216:Captopril