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European Heart Journal 1999 20(22):1647-1656; doi:10.1053/euhj.1999.1693
Copyright © 1999 by the European Society of Cardiology.
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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

R. Willenheimerf1, E. Rydberg, L. Öberg, S. Juul-Möller and L. Erhardt

Department of Cardiology, Malmö University Hospital, Lund University, Malmö, Sweden

revised May 11, 1999; accepted May 12, 1999

Abstract

Aims To assess the effects of 6 months intervention with ramipril on resting and post exercise left ventricular function in patients with stable ischaemic heart disease and preserved left ventricular systolic function.

Methods and Results Patients (n=98, age 65±9 years, 37% women) were randomized to double-blind treatment with ramipril 5mg.day–1(n=32), ramipril 1·25mg.day–1(n=34), or placebo (n=32). Resting and post maximum exercise echocardiography/Doppler examinations were performed at baseline and after 6 months. Changes over 6 months in resting transmitral E-wave deceleration time (Edt) and Edt adjusted for heart rate (Edt/RR) differed between the ramipril 5mg, ramipril 1·25mg, and placebo groups: Edt 24±82, –1±69, and –29±64ms, respectively, P=0·012; Edt/RR 30±105, 2±61, and –28±69ms, 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±101ms, respectively,P =0·029. No differences in E/A indices were noted. Resting atrioventricular plane displacement improved in the combined ramipril groups vs the placebo group: 0·2±0·8 vs –0·2±1·3mm, P<0·05.

Conclusion Six months ramipril treatment in patients with stable ischaemic heart disease and preserved left ventricular systolic function improved resting left ventricular function and reduced the exercise induced diastolic filling abnormalities usually seen in these patients.

Key Words: Angiotensin converting enzyme inhibitor, ischaemic heart disease, left ventricular function, diastolic function, exercise

f1 Correspondence: Dr Ronnie Willenheimer, Department of Cardiology, Malmö University Hospital, S-205 02 Malmö, Sweden.

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F. Enseleit, T.F. Luscher, and F. Ruschitzka
Angiotensin-converting enzyme inhibition and endothelial dysfunction: focus on ramipril
Eur. Heart J. Suppl., January 1, 2003; 5(suppl_A): A31 - A36.
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