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Reduced left ventricular diastolic asynchrony after captopril in single vessel coronary artery disease
1Second Department of Internal Medicine, Fukuoka University School of Medicine, Japan.
Insights
Captopril effectively reduces left ventricular asynchrony in patients with stable angina. However, it does not improve global diastolic function when it is affected by systolic dysfunction.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Left ventricular diastolic dysfunction often precedes systolic abnormalities in coronary artery disease.
- Stable angina patients with left anterior descending coronary artery stenosis exhibit impaired diastolic function.
Purpose of the Study:
- To evaluate the effect of captopril on left ventricular diastolic function in patients with stable effort angina.
- To assess if captopril can improve diastolic parameters in this patient group.
Main Methods:
- Radionuclide ventriculography was used to assess cardiac function before and after captopril administration.
- The study included 10 stable effort angina patients and 8 healthy controls.
Main Results:
- Patients with angina showed reduced global peak filling rate (PFR) and increased left ventricular diastolic asynchronous index (delta t).
- Captopril significantly reduced the diastolic asynchronous index (delta t) in angina patients (p < 0.05).
- Global PFR and regional cardiac function were not significantly affected by captopril.
Conclusions:
- Captopril improves left ventricular asynchrony in patients with stable angina.
- Captopril does not improve global diastolic function if it is already compromised by systolic dysfunction.
Abstract:
Impaired left ventricular diastolic function is often found preceding systolic functional abnormality in coronary artery disease. To assess whether captopril improves diastolic function, radionuclide ventriculography was performed before and 1 h after captopril administration in 10 stable effort angina patients with severe isolated stenosis of the left anterior descending coronary artery and in 8 controls. Resting global peak filling rate (PFR) was significantly (p < 0.05) reduced in association with significantly (p < 0.01) increased left ventricular diastolic asynchronous index (delta t) in patients with angina pectoris. Neither global PFR nor regional cardiac function was affected by captopril, although delta t was significantly (p < 0.05) reduced from 70 +/- 18 (SD) to 51 +/- 25 ms in patients with angina pectoris. A significant (p < 0.01) correlation was observed between percentage changes in peak ejection rate and in PFR in all subjects. Thus, captopril improves left ventricular asynchrony in patients with stable angina, although global diastolic function affected by systolic function remains unchanged.