Effects of Enalaprilat on Regional Wall Stress in Patients with Angina Pectoris.
Left ventricle (LV) cineventriculograms silhouettes in the right anterior oblique projection with simultaneous pressure micromanometry were assessed before and 10 min after administration of 1.25 mg enalaprilat intravenously to 10 patients with angina pectoris undergoing diagnostic cardiac catheterization. Cineventriculograms were divided into 20 areas using a modified Leighton's method for segmentalization of the LV and computed by the Janz's method for regional wall stress. Enalaprilat reduced preload and afterload in all cases. There was significant reduction in regional wall stress in 15 of the 20 segments after enalaprilat administration compared with baseline analysis. Segments without significant reduction in wall stress wee apical. There was significant reduction in global wall stress after enalaprilat. Thus, enalaprilat, in addition to improve hemodynamics decreasing both preload and afterload, reduces LV wall stress both regional and global. Clinical implications of these findings are in agreement with the wall stress reduction for prevention of ventricular remodeling with this agent in postinfarction patients.
González-Fernández
Robert A.
RA
Department of Medicine, Cardiology Section, University of Puerto Rico Medical Sciences Campus, and the Cardiovascular Research Unit from the San Juan City Hospital and the Puerto Rico Cardiovascular Center, Rio Piedras, Puerto Rico.
Altieri
Pablo I.
PI
Banchs
Hector L.
HL
Escobales
Nelson
N