Related Experiment Videos
Recognition and management of asymptomatic patients with left ventricular dysfunction
1Department of Medicine/Division of Cardiology, University of Texas Health Science Center, San Antonio 78284-7872.
The American Journal of Cardiology
|June 4, 1992
Summary
Newer congestive heart failure therapies, including angiotensin-converting enzyme (ACE) inhibitors, improve survival in symptomatic patients. However, their benefit for asymptomatic patients with reduced left ventricular (LV) function remains unclear.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Congestive heart failure (CHF) therapy has advanced with vasodilator drugs.
- Vasodilator therapy, combined with digitalis and diuretics, improves left ventricular (LV) ejection fraction, functional capacity, and quality of life.
Purpose of the Study:
- To evaluate therapeutic approaches for asymptomatic patients with significantly depressed LV function.
- To consider the use of cardiac glycosides and angiotensin-converting enzyme (ACE) inhibitors in this patient group.
Main Methods:
- Review of studies published since 1988 on vasodilator and ACE inhibitor therapy.
- Consideration of objective measurements of ventricular function for prognosis in asymptomatic patients.
Main Results:
- ACE inhibitors improve survival in symptomatic CHF patients.
- Data are lacking to confirm improved survival with interventions in asymptomatic patients with depressed LV function.
Conclusions:
- Prognosis for asymptomatic patients with depressed LV function should rely on objective measurements, not NYHA class.
- Therapeutic decisions for asymptomatic patients must be individualized, weighing potential benefits against current evidence.