ACE inhibition with ramipril improves left ventricular function at rest and post exercise in patients with stable ischaemic heart disease and preserved left ventricular systolic function

Aims To assess the effects of 6 months intervention with ramipril on restin g and post exercise left ventricular function in patients with stable ischa emic heart disease and preserved left ventricular systolic function. Methods and Results Patients (n=98, age 65 +/- 9 years, 37% women) were ran domized to double-blind treatment with ramipril 5mg.day(-1) (n=32), ramipri l 1.25 mg.day(-1) (n=34), or placebo (n=32). Resting and post maximum exerc ise echocardiography/Doppler examinations were performed at baseline and af ter 6 months. Changes over 6 months in resting transmitral E-wave decelerat ion time (Edt) and Edt adjusted for heart rate (Edt/RR) differed between th e ramipril 5mg, ramipril 1.25 mg, and placebo groups: Edt 24+/-82, -1+/-69, and -29+/-64ms, respectively, P=0.012; Edt/RR 30+/-105, 2+/-61, and -28+/- 69 ms, respectively, P=0.015. Changes in the difference between resting and post exercise Edt/RR also varied between groups: -53+/-137, -28+/-118, and 35+/-101 ms, respectively, P=0.029. No differences in E/A indices were not ed. Resting atrioventricular plane displacement improved in the combined ra mipril groups vs the placebo group: 0.2+/-0.8 vs -0.2+/-1.3 mm, P<0.05. Conclusion Six months ramipril treatment in patients with stable ischaemic heart disease and preserved left ventricular systolic function improved res ting left ventricular function and reduced the exercise induced diastolic f illing abnormalities usually seen in these patients. (C) 1999 The European Society of Cardiology.