CARDIAC PROTECTION BY LONG-TERM TREATMENT WITH CAPTOPRIL IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

Objectives To assess the effects of long-term angiotensin-converting e nzyme (ACE) inhibitor treatment with captopril on cardiac function in acute myocardial infarction (AMI). Methods One hundred and one patient s with AMIwho were admitted to hospital within 72 hours of the onset o f symptoms with no cardiogenic shock were randomly allocated to captop ril (n = 52; group I) and conventional treatment (n = 49; group II). L eft ventricular (LV) systolic performance and diastolic transmitral fl ow velocity profiles were assessed by Doppler echocardiography at admi ssion (1.2 +/- 1.1 days), before discharge (27 +/- 10 days) and during follow-up (363 +/- 31 days). Results At one year follow-up, in group I LV end-diastolic volume decreased, and ejection fraction increased d ue to a disproportionate decrease in end-systolic volume. The incidenc e of cardiac dilatation was reduced. LV early diastolic filling veloci ty (E) increased and late atrial filling velocity (A) decreased, resul ting in an elevation of E/A ratio. However, the mean values of LV syst olic and diastolic functional parameters were unchanged in group II. C onclusions Long-term treatment with captopril exerts a beneficial effe ct on cardiac protection for patients with AMI.