Related Experiment Videos
Long-term effect of angiotensin-converting enzyme inhibitor in volume overloaded heart during growth: a controlled
Y Mori1, M Nakazawa, H Tomimatsu
1Department of Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University. moriy@d7.dion.ne.jp
Insights
Long-term angiotensin-converting enzyme (ACE) inhibitor therapy effectively reduces left ventricular (LV) volume overload and hypertrophy in children with heart valve disease. This treatment helps manage excessive increases in LV mass and volume during growth.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Pharmacology
- Echocardiography
Background:
- Adult studies show angiotensin-converting enzyme (ACE) inhibitors mitigate volume overload and left ventricular (LV) hypertrophy in aortic or mitral regurgitation.
- Growing children with these conditions may benefit from similar interventions.
Purpose of the Study:
- To determine if long-term angiotensin-converting enzyme (ACE) inhibitor therapy reduces excessive increases in left ventricular (LV) mass and volume in pediatric patients with aortic or mitral regurgitation.
Main Methods:
- A cohort of 24 children (0.3-16 years) with aortic or mitral regurgitation was studied.
- Left ventricular (LV) size, systolic function, and mass were assessed via echocardiography at baseline and after an average 3.4-year follow-up.
- Patients were randomized into an ACE inhibitor group (n=12) or a control group (n=12).
Main Results:
- The ACE inhibitor group showed a decrease in LV end-diastolic dimensions Z value (mean change -0.25 ± 0.33) compared to an increase in the control group (mean change +0.42 ± 0.48) (p=0.0007).
- Normalized LV mass also reduced in the ACE inhibitor group (mean change -72 ± 89% of normal) versus an increase in the control group (mean change +37 ± 35% of normal) (p=0.0007).
- Baseline LV parameters were similar between groups.
Conclusions:
- Long-term angiotensin-converting enzyme (ACE) inhibitor treatment is effective in managing left ventricular (LV) volume overload in children.
- ACE inhibitors also successfully reduce left ventricular (LV) hypertrophy in growing children experiencing LV volume overload due to aortic or mitral regurgitation.
Objectives:
This study examined whether long-term therapy with an angiotensin-converting enzyme (ACE) inhibitor reduces excessive increases in left ventricular (LV) mass as well as volume in growing children with aortic regurgitation or mitral regurgitation.
Background:
The ACE inhibitor reduces volume overload and LV hypertrophy in adults with aortic or mitral regurgitation.
Methods:
This study included 24 patients whose ages ranged from 0.3 to 16 years at entry to the study. On echocardiography, we measured LV size, systolic function and mass. After obtaining baseline data, patients were allocated into two groups. Twelve patients were given an ACE inhibitor (ACE inhibitor group), and 12 patients were not (control group). Echo parameters were again assessed after an average 3.4 years of follow-up.
Results:
Left ventricular parameters at baseline in the two groups were similar. The Z value of LV end-diastolic dimensions decreased from +0.82 +/- 0.55 to +0.57 +/- 0.58 in the ACE inhibitor group, whereas it increased from +0.73 +/- 0.85 to +1.14 +/- 1.04 in the control group (mean change -0.25 +/- 0.33 for the ACE inhibitor group vs. +0.42 +/- 0.48 for the control group, p = 0.0007). The mass normalized to growth also reduced from 221 +/- 93% to 149 +/- 44% of normal in the ACE inhibitor group and increased from 167 +/- 46% to 204 +/-59% of normal in the control group (mean change -72 +/- 89% of normal for the ACE inhibitor group vs. +37 +/- 35% of normal for the control group, p = 0.0007).
Conclusions:
Long-term treatment with ACE inhibitors is effective in reducing not only LV volume overload but also LV hypertrophy in the hearts of growing children with LV volume overload.