ACE inhibition with ramipril improves left ventricular function at rest and post exercise in patients with stable...

Area of Science:

• Cardiology
• Pharmacology
• Echocardiography

Background:

• Stable ischemic heart disease (IHD) often presents with preserved left ventricular systolic function but impaired diastolic function.
• Diastolic dysfunction can manifest as abnormal left ventricular filling patterns, particularly during exercise.
• Understanding interventions that can improve diastolic function in IHD is crucial for patient management.

Purpose of the Study:

• To evaluate the impact of a 6-month ramipril intervention on resting and post-exercise left ventricular function.
• To assess changes in diastolic function parameters in patients with stable IHD and preserved ejection fraction.

Main Methods:

• A randomized, double-blind trial involving 98 patients with stable IHD.
• Patients received ramipril (5 mg or 1.25 mg daily) or placebo for 6 months.
• Resting and post-exercise echocardiography/Doppler assessments were conducted at baseline and follow-up.

Main Results:

• Ramipril treatment significantly improved resting transmitral E-wave deceleration time (Edt) and heart rate-adjusted Edt (Edt/RR).
• Changes in the difference between resting and post-exercise Edt/RR varied significantly between ramipril and placebo groups.
• Resting atrioventricular plane displacement showed improvement in combined ramipril groups compared to placebo.

Conclusions:

• Six months of ramipril therapy enhances resting left ventricular diastolic function in patients with stable IHD.
• Ramipril effectively mitigates exercise-induced diastolic filling abnormalities in this patient population.
• The findings support ramipril's role in improving cardiac function in IHD patients with preserved systolic function.