European Heart Journal (1990) 11, {Supplement B), 147-156
Preventive treatment of asymptomatic left ventricular dysfunction following myocardial infarction N.
SHARPE, J. MURPHY, H.
SMITH AND S.
HANNAN
Department of Medicine, University of Auckland School of Medicine, Auckland, New Zealand
KEY WORDS: Captopril, frusemide, left ventricular dysfunction, myocardial infarction.
Introduction The aims for treatment of congestive heart failure can be well met by modern therapy and the use of angiotensin-converting enzyme inhibitors in particular. These agents can produce sustained haemodynamic and symptomatic improvement, improved ventricular function and survival1'-31. However, such treatment is still essentially palliative as severe ventricular dysfunction is often present at the time of clinical presentation. A more substantial improvement might be achieved through earlier intervention and a preventive approach to treatment to delay progressive ventricular
dilatation and the occurrence of clinical heart - The potential for progressive ventricular dilatation that exists following myocardial infarction1 •" and the prognostic importance of this161, suggests that a preventive approach in this xnia & ™&l ** beneficial. This rationale is ™PP°rted by experimental animal studies which have shown that converting-enzyme inhibition «"> r e d u c e ventricular dilatation following myocardial mfarction and improve survival1 '. In a recent clinical s t u d v w e h a v e d e m o "strated that converting-enzyme inhibition can im rove P asymptomatic left ventricular dysfunction following myocardial infarction!'. The present report relates to an extension of that Supported by grants from the National Heart Foundation s t u d i n a i a r g e r n u m b e r o f patientS with the aim of New Zealand and E. R. Squibb and Sons. r J • Z •• J . • . c „ , r. r» KI cu r. _ . c of studying baseline determinants of response J b Correspondence: Dr D. N. Sharpe, Department of . . , .. Medicine, Auckland Hospital, Auckland Zealand. 0195-668X/9O/0B147 + 10 $03.00/0
l,
New
failure
and the endpoint of clinical heart failure, m addition to left ventricular volume changes. © 1990 The European Society of Cardiology
Downloaded from http://eurheartj.oxfordjournals.org/ by guest on June 5, 2016
Progressive asymptomatic ventricular dilatation can occur following myocardial infarction and severe ventricular dysfunction is often present by the time clinical congestive heart failure occurs. In a randomized, double-blind trial, the effects of captopril 25mg tid, frusemide 40mg daily and placebo were studied in 90 patients with asymptomatic left ventricular dysfunction (ejection fraction
Preventive treatment of asymptomatic left ventricular dysfunction following myocardial infarction N.
SHARPE, J. MURPHY, H.
SMITH AND S.
HANNAN
Department of Medicine, University of Auckland School of Medicine, Auckland, New Zealand
KEY WORDS: Captopril, frusemide, left ventricular dysfunction, myocardial infarction.
Introduction The aims for treatment of congestive heart failure can be well met by modern therapy and the use of angiotensin-converting enzyme inhibitors in particular. These agents can produce sustained haemodynamic and symptomatic improvement, improved ventricular function and survival1'-31. However, such treatment is still essentially palliative as severe ventricular dysfunction is often present at the time of clinical presentation. A more substantial improvement might be achieved through earlier intervention and a preventive approach to treatment to delay progressive ventricular
dilatation and the occurrence of clinical heart - The potential for progressive ventricular dilatation that exists following myocardial infarction1 •" and the prognostic importance of this161, suggests that a preventive approach in this xnia & ™&l ** beneficial. This rationale is ™PP°rted by experimental animal studies which have shown that converting-enzyme inhibition «"> r e d u c e ventricular dilatation following myocardial mfarction and improve survival1 '. In a recent clinical s t u d v w e h a v e d e m o "strated that converting-enzyme inhibition can im rove P asymptomatic left ventricular dysfunction following myocardial infarction!'. The present report relates to an extension of that Supported by grants from the National Heart Foundation s t u d i n a i a r g e r n u m b e r o f patientS with the aim of New Zealand and E. R. Squibb and Sons. r J • Z •• J . • . c „ , r. r» KI cu r. _ . c of studying baseline determinants of response J b Correspondence: Dr D. N. Sharpe, Department of . . , .. Medicine, Auckland Hospital, Auckland Zealand. 0195-668X/9O/0B147 + 10 $03.00/0
l,
New
failure
and the endpoint of clinical heart failure, m addition to left ventricular volume changes. © 1990 The European Society of Cardiology
Downloaded from http://eurheartj.oxfordjournals.org/ by guest on June 5, 2016
Progressive asymptomatic ventricular dilatation can occur following myocardial infarction and severe ventricular dysfunction is often present by the time clinical congestive heart failure occurs. In a randomized, double-blind trial, the effects of captopril 25mg tid, frusemide 40mg daily and placebo were studied in 90 patients with asymptomatic left ventricular dysfunction (ejection fraction
