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Changes in left ventricular mass and volumes in patients receiving angiotensin-converting enzyme inhibitor therapy for left ventricular dysfunction after Q-wave myocardial infarction.
Am Heart J. 1998 Aug; 136(2):269-75.AH

Abstract

OBJECTIVES

We evaluated global and segmental left ventricular (LV) mass and LV mass/volume ratio in patients with LV dysfunction receiving angiotensin-converting enzyme (ACE) inhibitor therapy after acute myocardial infarction (MI).

BACKGROUND

ACE inhibitors attenuate LV dilatation and compensatory hypertrophy after acute MI in animal models. However, LV remodeling in patients after acute MI has been largely defined on the basis of changes in chamber volume alone.

METHODS AND RESULTS

Twenty-nine patients with LV ejection fraction <40% received the ACE inhibitor ramipril (range 2.5 to 20 mg/day) within 5 days of their first Q-wave MI. Magnetic resonance imaging was performed at baseline and at 3 months, providing global and regional LV volumes and mass from summated serial short-axis slices. Mean arterial blood pressure was unchanged from baseline to 3-month follow-up (89 +/- 10 to 92 +/- 17 mm Hg). LV mass decreased (90 +/- 25 to 77 +/- 21 gm/m2, p < 0.0005) as LV end-diastolic volumes increased (65 +/- 13 to 73 +/- 22 ml/m2, p < 0.01). Global LV mass to volume ratio decreased from 1.40 +/- 0.28 to 1.08 +/- 0.18 gm/ml (p < 0.0001), as did circumferential wall thickness to volume ratio of noninfarcted myocardium at the base of the LV (0.06 +/- 0.02 to 0.05 +/- 0.02 mm/ml, p < 0.001). LV ejection fraction increased from 35 +/- 6 to 40 +/- 9% (p < 0.001) in the presence of an increase in calculated end-systolic wall stress (185 +/- 57 to 227 +/- 54 gm/cm2, p < 0.01).

CONCLUSIONS

ACE inhibitor therapy was associated with improved LV function in the face of a decrease in mass to volume ratio of the LV as well as a decrease in wall thickness to volume ratio of noninfarcted myocardium. Whether ACE inhibitor therapy had direct or indirect effects on these changes in LV mass and function are open questions that require further investigation.

Authors+Show Affiliations

Birmingham Veteran Affairs Medical Center, University of Alabama at Birmingham, the Department of Medicine, 35294, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9704689

Citation

Foster, R E., et al. "Changes in Left Ventricular Mass and Volumes in Patients Receiving Angiotensin-converting Enzyme Inhibitor Therapy for Left Ventricular Dysfunction After Q-wave Myocardial Infarction." American Heart Journal, vol. 136, no. 2, 1998, pp. 269-75.
Foster RE, Johnson DB, Barilla F, et al. Changes in left ventricular mass and volumes in patients receiving angiotensin-converting enzyme inhibitor therapy for left ventricular dysfunction after Q-wave myocardial infarction. Am Heart J. 1998;136(2):269-75.
Foster, R. E., Johnson, D. B., Barilla, F., Blackwell, G. G., Orr, R., Roney, M., Stanley, A. W., Pohost, G. M., & Dell'Italia, L. J. (1998). Changes in left ventricular mass and volumes in patients receiving angiotensin-converting enzyme inhibitor therapy for left ventricular dysfunction after Q-wave myocardial infarction. American Heart Journal, 136(2), 269-75.
Foster RE, et al. Changes in Left Ventricular Mass and Volumes in Patients Receiving Angiotensin-converting Enzyme Inhibitor Therapy for Left Ventricular Dysfunction After Q-wave Myocardial Infarction. Am Heart J. 1998;136(2):269-75. PubMed PMID: 9704689.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in left ventricular mass and volumes in patients receiving angiotensin-converting enzyme inhibitor therapy for left ventricular dysfunction after Q-wave myocardial infarction. AU - Foster,R E, AU - Johnson,D B, AU - Barilla,F, AU - Blackwell,G G, AU - Orr,R, AU - Roney,M, AU - Stanley,A W,Jr AU - Pohost,G M, AU - Dell'Italia,L J, PY - 1998/8/15/pubmed PY - 2001/3/28/medline PY - 1998/8/15/entrez SP - 269 EP - 75 JF - American heart journal JO - Am Heart J VL - 136 IS - 2 N2 - OBJECTIVES: We evaluated global and segmental left ventricular (LV) mass and LV mass/volume ratio in patients with LV dysfunction receiving angiotensin-converting enzyme (ACE) inhibitor therapy after acute myocardial infarction (MI). BACKGROUND: ACE inhibitors attenuate LV dilatation and compensatory hypertrophy after acute MI in animal models. However, LV remodeling in patients after acute MI has been largely defined on the basis of changes in chamber volume alone. METHODS AND RESULTS: Twenty-nine patients with LV ejection fraction <40% received the ACE inhibitor ramipril (range 2.5 to 20 mg/day) within 5 days of their first Q-wave MI. Magnetic resonance imaging was performed at baseline and at 3 months, providing global and regional LV volumes and mass from summated serial short-axis slices. Mean arterial blood pressure was unchanged from baseline to 3-month follow-up (89 +/- 10 to 92 +/- 17 mm Hg). LV mass decreased (90 +/- 25 to 77 +/- 21 gm/m2, p < 0.0005) as LV end-diastolic volumes increased (65 +/- 13 to 73 +/- 22 ml/m2, p < 0.01). Global LV mass to volume ratio decreased from 1.40 +/- 0.28 to 1.08 +/- 0.18 gm/ml (p < 0.0001), as did circumferential wall thickness to volume ratio of noninfarcted myocardium at the base of the LV (0.06 +/- 0.02 to 0.05 +/- 0.02 mm/ml, p < 0.001). LV ejection fraction increased from 35 +/- 6 to 40 +/- 9% (p < 0.001) in the presence of an increase in calculated end-systolic wall stress (185 +/- 57 to 227 +/- 54 gm/cm2, p < 0.01). CONCLUSIONS: ACE inhibitor therapy was associated with improved LV function in the face of a decrease in mass to volume ratio of the LV as well as a decrease in wall thickness to volume ratio of noninfarcted myocardium. Whether ACE inhibitor therapy had direct or indirect effects on these changes in LV mass and function are open questions that require further investigation. SN - 0002-8703 UR - https://www.unboundmedicine.com/medline/citation/9704689/Changes_in_left_ventricular_mass_and_volumes_in_patients_receiving_angiotensin_converting_enzyme_inhibitor_therapy_for_left_ventricular_dysfunction_after_Q_wave_myocardial_infarction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(98)00156-2 DB - PRIME DP - Unbound Medicine ER -