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European Heart Journal 1993 14(2):259-266;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Effects of early use of captopril on haemodynamics and short-term ventricular remodelling in acute anterior myocardial infarction

J. GALCERA-TOMAS*,, J. ANTONIO NUñO DE LA ROSA{dagger}, G. TORRES-MARTINEZ, P. RODRIGUEZ-GARCIA, F. J. CASTILLO-SORIA, A. CANTON-MARTINEZ*, J. V. CAMPOS-PERIS, F. PICO-ARACIL, J. A. RUIZ-ROS and J. A. RUIPEREZ-ABIZANDA{ddagger}

*Coronary Care Unit University Hospital "Virgen de la Arrixaca" Murcia, Spain
{dagger}Nuclear Medicine, University Hospital Virgen de la Arrixaca Murcia, Spain
{ddagger}Cardiology Department, University Hospital Virgen de la Arrixaca Murcia, Spain

Received 22 November 1991; revised 28 May 1992; .

Correspondence: José Galcerá Tomás. Coronary Care Unit, Hospital Universitario virgen de la Arrixaca, El Palmar, Carretera Cartagena, Murcia, Spain

Abstract

To determine whether ventricular short-term enlargement following acute myocardial infarction is related to increased left filling pressures and whether early treatment with captopril alters this process we studied 68 patients with a first acute myocardial infarction. Forty patients with a pulmonary capillary pressure equal or above 17 mm Hg were randomized to treatment with conventional therapy plus captopril(n 20) or placebo(n 20), in a double blind fashion. Tile remaining 28 patients (non-dysfunction group) were treated conventionally. During the first 72 h, afterload showed a prompt decrease in the captopril group as compared to placebo. Changes from baseline to 14 days in end-diastolic and end-systolic left ventricular volume indexes determined by radionuclide ventriculography were: non-dysfunction, 85.6( ± 21) vs 88(±20) and 44(±17) vs 44(±17)ml. m–2 captopril(n20), 96.6(±18) vs 99(±19) and 66(±22) vs 65(±22)ml. m–2; placebo(n 20), 96(±25) vs 113(±19) (P <0.001) and 63(±18) vs 74(±22)ml. m–2 (P <0.01)

This study indicates that short-term ventricular enlargement is related to the degree of ventricular dysfunction and that captopril may improve this process.

Key Words: Myocardial infarction • Captopril • ventricular remodelling


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