Long-term effects of perindopril on left ventricular structure and function in patients with stable coronary artery disease: a conventional and Doppler tissue echocardiographic pilot study.
OBJECTIVE
The aim of this study was to investigate the long-term effects of perindopril on left ventricular (LV) systolic and diastolic function in patients with stable coronary artery disease who had previously undergone coronary artery bypass graft.


METHODS
Thirteen patients (12 male and one female patient) were treated with perindopril 8 mg/day and 13 (nine male and four female patients) with placebo, and both groups underwent conventional and Doppler tissue echocardiography (DTE) at baseline and after 12, 24, 36 and 47 months. DTE was sampled at the four sites of the mitral annulus and peak velocity (pv) and the time-velocity integral (tvi) of systolic (S) and diastolic (E and A) waves were calculated.


RESULTS
During the 47 months of follow-up, ejection fraction significantly increased in the perindopril group from 58 +/- 10 to 69 +/- 6% (P < 0.01) without any significant change in LV volumes. LV shortening and relaxation, assessed by DTE, also significantly increased: Stvi from 1.57 +/- 0.18 to 1.95 +/- 0.19 cm (P < 0.01) and Etvi from 0.95 +/- 0.23 to 1.37 +/- 0.59 cm (P < 0.05). There were no changes in ejection fraction (64 +/- 6 vs. 65 +/- 8%; P = not significant) or S or E waves in the placebo group, but a significant increase in LV diastolic volume. Blood pressure remained unchanged in both groups.


CONCLUSIONS
Our data suggest that perindopril improves both systolic and diastolic LV myocardial performance, a beneficial effect that may be due to the previously demonstrated biological, anti-ischemic and endothelium-dependent action of perindopril.
Pelà
Giovanna
G
Department of Internal Medicine, Nephrology and Prevention Sciences, Italy. giovanna.pela@unipr.it
Pattoneri
Paolo
P
Passera
Mariadele
M
Tirabassi
Giovanni
G
Reverberi
Claudio
C
Montanari
Alberto
A
Gherli
Tiziano
T
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D003324:Coronary Artery Disease / Q000473:pathology* / Q000503:physiopathology*; D004311:Double-Blind Method; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000494:pharmacology*; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril