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Effects of angiotensin-converting enzyme inhibition on mitral regurgitation severity, left ventricular size, and functional capacity.
Am Heart J. 2005 Nov; 150(5):1106.AH

Abstract

BACKGROUND

Mitral regurgitation (MR) is a progressive disorder that leads to left ventricular (LV) dilatation and dysfunction. Previous small studies have shown conflicting results regarding the benefits of afterload reduction for MR.

METHODS

We assessed by serial echocardiography the effects of ramipril on MR severity and LV size by a number of quantitative methods in 26 asymptomatic patients with moderate to severe MR at baseline and again after 6 months of ramipril treatment. We also evaluated exercise capacity, neurohormonal levels, and the Minnesota Living With Heart Failure score.

RESULTS

Despite a significant reduction in blood pressure with ramipril, there was no change in MR severity. MR severity, as assessed by effective regurgitant orifice area, was reduced in individuals with baseline systolic blood pressure (SBP) > or = 140 mm Hg (55.1 +/- 26 vs 37.4 +/- 35.4 mm2, P = .03), but not in individuals with SBP < 140 mm Hg (39.7 +/- 37.7 vs 46.1 +/- 34.1 mm2, P = not significant). Neither LV cavity size, exercise capacity, nor the Minnesota Living With Heart Failure score exhibited a significant change.

CONCLUSIONS

Patients with MR do not experience significant changes in MR severity, LV size, or functional status after 6 months of treatment with angiotensin-converting enzyme inhibition. However, patients with SBP > or = 140 mm Hg represent a subgroup that shows reduction in MR. These data are consistent with current American College of Cardiology/American Heart Association guidelines, which reserve the use of afterload reduction for MR patients with systemic hypertension or LV dysfunction.

Authors+Show Affiliations

Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA. kharris@mplsheart.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16291006

Citation

Harris, Kevin M., et al. "Effects of Angiotensin-converting Enzyme Inhibition On Mitral Regurgitation Severity, Left Ventricular Size, and Functional Capacity." American Heart Journal, vol. 150, no. 5, 2005, p. 1106.
Harris KM, Aeppli DM, Carey CF. Effects of angiotensin-converting enzyme inhibition on mitral regurgitation severity, left ventricular size, and functional capacity. Am Heart J. 2005;150(5):1106.
Harris, K. M., Aeppli, D. M., & Carey, C. F. (2005). Effects of angiotensin-converting enzyme inhibition on mitral regurgitation severity, left ventricular size, and functional capacity. American Heart Journal, 150(5), 1106.
Harris KM, Aeppli DM, Carey CF. Effects of Angiotensin-converting Enzyme Inhibition On Mitral Regurgitation Severity, Left Ventricular Size, and Functional Capacity. Am Heart J. 2005;150(5):1106. PubMed PMID: 16291006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of angiotensin-converting enzyme inhibition on mitral regurgitation severity, left ventricular size, and functional capacity. AU - Harris,Kevin M, AU - Aeppli,Dorothee M, AU - Carey,Charles F, PY - 2005/04/06/received PY - 2005/07/28/accepted PY - 2005/11/18/pubmed PY - 2005/12/31/medline PY - 2005/11/18/entrez SP - 1106 EP - 1106 JF - American heart journal JO - Am Heart J VL - 150 IS - 5 N2 - BACKGROUND: Mitral regurgitation (MR) is a progressive disorder that leads to left ventricular (LV) dilatation and dysfunction. Previous small studies have shown conflicting results regarding the benefits of afterload reduction for MR. METHODS: We assessed by serial echocardiography the effects of ramipril on MR severity and LV size by a number of quantitative methods in 26 asymptomatic patients with moderate to severe MR at baseline and again after 6 months of ramipril treatment. We also evaluated exercise capacity, neurohormonal levels, and the Minnesota Living With Heart Failure score. RESULTS: Despite a significant reduction in blood pressure with ramipril, there was no change in MR severity. MR severity, as assessed by effective regurgitant orifice area, was reduced in individuals with baseline systolic blood pressure (SBP) > or = 140 mm Hg (55.1 +/- 26 vs 37.4 +/- 35.4 mm2, P = .03), but not in individuals with SBP < 140 mm Hg (39.7 +/- 37.7 vs 46.1 +/- 34.1 mm2, P = not significant). Neither LV cavity size, exercise capacity, nor the Minnesota Living With Heart Failure score exhibited a significant change. CONCLUSIONS: Patients with MR do not experience significant changes in MR severity, LV size, or functional status after 6 months of treatment with angiotensin-converting enzyme inhibition. However, patients with SBP > or = 140 mm Hg represent a subgroup that shows reduction in MR. These data are consistent with current American College of Cardiology/American Heart Association guidelines, which reserve the use of afterload reduction for MR patients with systemic hypertension or LV dysfunction. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16291006/Effects_of_angiotensin_converting_enzyme_inhibition_on_mitral_regurgitation_severity_left_ventricular_size_and_functional_capacity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00751-9 DB - PRIME DP - Unbound Medicine ER -