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[Echocardiographic evaluation of left ventricular function in patients after myocardial infarction treated with
R Trojnar1, B Rymar, A Wysokiński
1Katedry i Kliniki Kardiologii Ak. Med, Lublinie.
Insights
Enalapril improved left ventricular ejection fraction and contractility in patients post-myocardial infarction. The drug enhanced diastolic function, indicated by changes in left ventricular filling patterns.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Post-myocardial infarction (MI) patients often experience left ventricular (LV) dysfunction.
- Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, is used to manage cardiovascular conditions.
Purpose of the Study:
- To evaluate the effects of enalapril on left ventricular contractility and diastolic function in patients after myocardial infarction.
- To assess changes in echocardiographic parameters related to LV filling and contractility.
Main Methods:
- Thirty patients (24 men, 6 women) aged 40-56 years, 6-18 months post-MI, received enalapril (5-10 mg/day) for six weeks.
- Two-dimensional echocardiography and Doppler examinations were performed before and after enalapril treatment.
- Analyzed parameters included ejection fraction, LV contractility, early diastolic filling rate (EDF), late diastolic filling rate (LDF), EDF/LDF ratio, deceleration time (dec. EDF), and early diastolic slope (EF sl.).
Main Results:
- Enalapril increased ejection fraction and contractility in non-necrotic LV segments.
- No significant effect was observed on the contractility index.
- Maximal late diastolic filling rate (LDF) significantly decreased, while the early diastolic slope (EF sl.) significantly increased.
Conclusions:
- Enalapril administration improved systolic function (ejection fraction and contractility) in post-MI patients.
- The observed changes in left ventricular filling profile suggest an improvement in diastolic function.
- Enalapril may be beneficial in managing cardiac remodeling and function after myocardial infarction.
Abstract:
The studies were carried out in 30 patients (24 men and six women) aged 40-56 years, mean age 51 years after myocardial infarction in whom enalapril in doses 5-10 mg daily, mean dose 8,5 mg daily was added to drugs used as yet. This drug was administered for six weeks. The patients had myocardial infarction 6-18 months before their inclusion to the studies. In all patients two-dimensional echocardiographic and Doppler examinations were performed twice: before and after the treatment with enalapril. Left ventricular contractility disturbances and the following parameters were analysed: maximal early diastolic filling rate (EDF), maximal late diastolic filling rate (LDF), EDF/LDF ratio and early diastolic deceleration time (dec. EDF) and early diastolic slope (EF sl.). Enalapril administered in patients after myocardial infarction caused an increase of ejection fraction and increase of the contractility of left ventricular muscle segments not involved by necrosis. It exerted, however, no effect on the changes of contractility index. After the treatment with enalapril the maximal late diastolic filling rate (LDF) was significantly decreased while early diastolic deceleration slope (EF sl.) was significantly increased. The observed influence of enalapril on the left ventricular filling profile may suggest an improvement of left ventricular diastolic function.