Related Experiment Video
Updated: Jun 22, 2026
Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
Published on: July 7, 2016
Long-term effects of perindopril on left ventricular structure and function in patients with stable coronary artery
Giovanna Pelà1, Paolo Pattoneri, Mariadele Passera
1Department of Internal Medicine, Nephrology and Prevention Sciences, Italy. giovanna.pela@unipr.it
Insights
Perindopril significantly improved left ventricular (LV) systolic and diastolic function in patients with coronary artery disease over 47 months. This study highlights perindopril
Area of Science:
- Cardiology
- Pharmacology
- Echocardiography
Background:
- Stable coronary artery disease (CAD) patients often have impaired left ventricular (LV) function post-coronary artery bypass graft (CABG).
- Long-term effects of angiotensin-converting enzyme inhibitors like perindopril on LV function in this population require further investigation.
Purpose of the Study:
- To evaluate the long-term impact of perindopril on both systolic and diastolic LV function.
- To assess changes in LV myocardial performance in patients with stable CAD after CABG.
Main Methods:
- A randomized, placebo-controlled trial involving 26 patients (13 perindopril, 13 placebo).
- Patients received perindopril 8 mg/day or placebo for 47 months.
- Conventional and Doppler tissue echocardiography (DTE) were used to assess LV function at baseline and multiple follow-up points.
Main Results:
- Perindopril significantly increased ejection fraction (58% to 69%) and LV shortening/relaxation (Stvi, Etvi) without altering LV volumes.
- The placebo group showed no significant changes in ejection fraction or myocardial contractility but had increased LV diastolic volume.
- Blood pressure remained stable in both groups throughout the study period.
Conclusions:
- Perindopril demonstrates a significant long-term benefit in improving both systolic and diastolic LV myocardial performance in stable CAD patients post-CABG.
- The observed benefits may stem from perindopril's known anti-ischemic and endothelium-dependent actions.
Objectives:
The aim of this study was to investigate the long-term effects of perindopril on left ventricular (LV) systolic and diastolic function in patients with stable coronary artery disease who had previously undergone coronary artery bypass graft.
Methods:
Thirteen patients (12 male and one female patient) were treated with perindopril 8 mg/day and 13 (nine male and four female patients) with placebo, and both groups underwent conventional and Doppler tissue echocardiography (DTE) at baseline and after 12, 24, 36 and 47 months. DTE was sampled at the four sites of the mitral annulus and peak velocity (pv) and the time-velocity integral (tvi) of systolic (S) and diastolic (E and A) waves were calculated.
Results:
During the 47 months of follow-up, ejection fraction significantly increased in the perindopril group from 58 +/- 10 to 69 +/- 6% (P < 0.01) without any significant change in LV volumes. LV shortening and relaxation, assessed by DTE, also significantly increased: Stvi from 1.57 +/- 0.18 to 1.95 +/- 0.19 cm (P < 0.01) and Etvi from 0.95 +/- 0.23 to 1.37 +/- 0.59 cm (P < 0.05). There were no changes in ejection fraction (64 +/- 6 vs. 65 +/- 8%; P = not significant) or S or E waves in the placebo group, but a significant increase in LV diastolic volume. Blood pressure remained unchanged in both groups.
Conclusion:
Our data suggest that perindopril improves both systolic and diastolic LV myocardial performance, a beneficial effect that may be due to the previously demonstrated biological, anti-ischemic and endothelium-dependent action of perindopril.