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09:37
Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure
Published on: December 2, 2014
Left ventricular filling after long-term angiotensin converting enzyme inhibition in congestive heart failure
L H Baur1, J J Schipperheyn, V M Cats
1Department of Cardiology, University Hospital Leiden, The Netherlands.
European Heart Journal
|November 1, 1992
Summary
Enalapril improved cardiac remodeling in heart failure patients by reducing ventricular dilation and stiffness. However, it did not significantly alter early diastolic relaxation parameters.
Area of Science:
- Cardiology
- Pharmacology
- Heart Failure Research
Background:
- Left ventricular relaxation is often impaired in patients with coronary artery disease and congestive heart failure.
- Ventricular dilation alters passive elastic properties in diastole, impacting overall heart function.
Purpose of the Study:
- To investigate the effects of enalapril on left ventricular diastolic properties in patients with congestive heart failure.
- To assess changes in diastolic function and ventricular stiffness following enalapril treatment.
Main Methods:
- Studied 11 patients with congestive heart failure (NYHA class II-IV) before and after 3 months of enalapril therapy.
- Utilized radionuclide angiography and simultaneous pressure-volume measurements for hemodynamic assessment.
- Analyzed systemic vascular resistance, left ventricular end-diastolic pressure, and end-diastolic volume index.
Main Results:
- Enalapril significantly reduced systemic vascular resistance and left ventricular end-diastolic pressure.
- Left ventricular end-diastolic volume index decreased significantly, indicating regression of ventricular dilation.
- Early diastolic relaxation indices (peak filling rate, time to peak filling rate, peak negative dP/dt, tau) showed no significant change.
- Increased diastolic pressure-volume relationship steepness indicated enhanced chamber stiffness, primarily due to geometric changes.
Conclusions:
- Enalapril-induced regression of cardiac remodeling in heart failure patients improves ventricular geometry and reduces chamber stiffness.
- These geometric improvements do not significantly alter intrinsic early diastolic relaxation parameters.
- The study highlights the impact of reverse remodeling on diastolic function beyond direct effects on relaxation mechanisms.
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