Mechanocardiographic effects of ACE-inhibitors

Twenty-one subjects who suffered a recent medium sized anterior myocardial infarction conditioning a mild congestive heart failure were randomly allocated to treatment with captopril (25 mg b.i.d., 10 pts) or placebo (11 pts). After 2 months of therapy the group on the active treatment showed a significant increase of apexcardiographic protodiastolic filling period duration reflecting a clear cut decrease of mean pulmonary capillary wedge pressure (from 14 +/- 2 to 7 +/- 3 mm Hg) while patients on placebo did not show any difference in respect to baseline. Neither treatment significantly modified the PEP/LVET ratio despite a significant increase of left ventricular ejection fraction in patients receiving captopril (from 37 +/- 4% to 43 +/- 5%). Cardiac response to ACE-inhibitors can thus be noninvasively monitored by apexcardiography.