Enalapril therapy and cardiac remodelling in sickle cell disease patients.
BACKGROUND
Angiotensin-converting enzyme inhibitors (ACEi) have been successfully used for patients with cardiac dysfunction after myocardial infarction.


OBJECTIVE
The aim of the present study was to investigate cardiac effects of ACEi in sickle cell disease (SCD) patients, as there are no previous reports regarding these effects.


METHODS
Enalapril was administered to 9 SCD patients with microalbuminuria. Nine SCD patients without microalbuminuria, matched according to age, diagnosis and levels of haemoglobin, haematocrit and foetal haemoglobin did not receive enalapril and were followed up as the control group during the same period of study. Echocardiograms were performed before the study entry and after 36 months of follow-up.


RESULTS
At 36 months of follow-up, significant increases in left ventricular mass, left ventricular mass index, posterior left ventricular wall thickness in end-diastole, interventricular septal wall thickness in end-diastole, and aortic root diameter values were seen in untreated, but not in enalapril-treated patients. No major changes were seen in left ventricular systolic diameter, diastolic dimension and ejection fraction, and left atrial diameter, in both groups, along the observational period.


CONCLUSIONS
The results of this study suggest that enalapril prevents cardiac remodelling in SCD patients. However, a large trial concerning the response to enalapril in patients with SCD should be carried out to further clarify this issue.
Lima
Carmen S P
CS
Haematology and Haemotherapy Centre, State University of Campinas, Campinas, São Paulo, Brazil. carmenl@fcm.unicamp.br
Ueti
Osvaldo M
OM
Ueti
Adriana A
AA
Franchini
Kleber G
KG
Costa
Fernando F
FF
Saad
Sara T O
ST
D000328:Adult; D000755:Anemia, Sickle Cell / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003971:Diastole; D004452:Echocardiography; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology; D011446:Prospective Studies; D013318:Stroke Volume; D020257:Ventricular Remodeling
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril