Enalapril (10 mg/day) in systemic sclerosis. One year, double blind, randomised study (ESS-1): electrocardiographic...

The ESS-1 study was designed to evaluate the long-term effects of enalapril (10 mg per day) on the cardiopulmonary system of patients with systemic sclerosis (SSc). The 3 months follow-up was completed by 41 patients (23 patients in enalapril group and 18 in placebo group). We analysed conventional time domain signal averaged ECG (SAECG). Late potentials were considered to be present in QRS duration (QRS) was > 114 ms or root mean square of last 40 ms (RMS40) was < 20 microV or terminal signal duration under 40 microV (LAS40) was > 38 ms at 40 Hz. At the beginning of study the prevalence of abnormal SAEG parameters was similar in both groups. We observed one abnormal parameter among 13% of patients in enalapril group and 16.7% of patients in placebo group. There were 2 abnormal parameters in 26.1% of patients in enalapril group and 16.7% of patients in placebo group. After three months of treatment we did not find any patient with 2 parameters of late potentials in enalapril group and only 8.7% of patients with one such parameter. In placebo group no substantial improvement was observed.

The 3 months enalapril treatment seems to decrease the incidence of late potentials in patients with systemic sclerosis.