EFFECTS OF LISINOPRIL ON CONGESTIVE-HEART-FAILURE IN NORMOTENSIVE PATIENTS WITH DIASTOLIC DYSFUNCTION BUT INTACT SYSTOLIC FUNCTION

This study examined the effects of lisinopril on diastolic function in 12 normotensive patients (mean age 72 years) with symptomatic congest ive heart failure, intact left ventricular systolic function and abnor mal diastolic function secondary to ischaemic heart disease in a place bo-controlled double blind crossover study, with each treatment dosed orally for 5 continuous weeks. Compared to placebo, lisinopril signifi cantly decreased blood pressure, increased plasma renin activity witho ut altering heart rate or plasma norepinephrine. There was no statisti cally significant improvement with lisinopril in radionuclide derived peak tilling rate and time to peak filling rate, in Doppler echocardio graphic measurements of the ratio of peak flow velocity in early diast ole to the peak flow velocity of atrial contraction (E:A ratio) and in visual analogue scales of symptoms. Thus, although angiotension conve rting enzyme inhibitors may have an established role in the treatment of heart failure secondary to left ventricular systolic dysfunction, i ts use in patients with isolated diastolic dysfunction remains unclear .