Related Experiment Videos
[Beneficial effects of enalapril on the diastolic ventricular function in Chagas myocardiopathy]
F E Szajnbok1, A C Barretto, C Mady
1Instituto do Coração do Hospital das Clínicas, FMUSP.
Insights
Enalapril significantly improved diastolic dysfunction in patients with Chagas
Area of Science:
- Cardiology
- Tropical Medicine
- Pharmacology
Background:
- Chagas' disease commonly leads to heart failure, characterized by ventricular dysfunction.
- Congestive heart failure in Chagas' disease necessitates effective therapeutic strategies.
- Ventricular arrhythmias are a significant complication in Chagas' cardiomyopathy.
Purpose of the Study:
- To assess the impact of enalapril on ventricular function in Chagas' disease patients with heart failure.
- To determine the effect of enalapril on the incidence of ventricular arrhythmias.
- To evaluate enalapril's efficacy in improving cardiac function parameters.
Main Methods:
- A randomized study involving 20 patients with Chagas' disease and congestive heart failure.
- Patients received either conventional treatment (control group) or conventional treatment plus enalapril.
- Evaluations included clinical examination, echocardiography, stress tests, and 24-hour Holter monitoring over two months.
Main Results:
- Enalapril group showed significant improvement in diastolic function (p=0.04).
- A trend towards improvement in systolic function (stroke volume, cardiac index) was observed in the enalapril group.
- The incidence of non-sustained ventricular tachycardia was similar between the enalapril and control groups.
Conclusions:
- Enalapril significantly improves diastolic dysfunction in heart failure patients with Chagas' disease.
- A tendency for systolic dysfunction improvement was noted after two months of enalapril treatment.
- Enalapril did not alter the incidence of stress test-induced arrhythmias in this cohort.
Purpose:
To verify the effect of enalapril on ventricular function and on the incidence of ventricular arrhythmias in patients with Chagas' disease with congestive heart failure.
Methods:
We studied 20 patients with Chagas' disease, aged between 24 to 64 (mean 44) years. There were 17 male. All patients have positive serologic blood tests for Chagas' disease (immunofluorescence and Machado-Guerreiro test), left ventricular diastolic diameter superior to 55mm and ejection fraction less than 0.60. The patients were divided aleatory in two groups: control group (CG) with 9 patients receiving conventional treatment (digital and diuretics) and enalapril group (EG), with 11 patients where enalapril was added to conventional treatment. The treatment was maintained during two months and the patients were evaluated at the beginning and at the end, when they were submitted to clinical examination, echo-doppler-cardiogram, stress test and 24h Holter monitoring. At two dimensional echocardiographic study we evaluate left ventricular and left atrial diameters, at doppler study the E/A relations, the systolic volume and cardiac index. At the stress test and Holter monitoring we evaluate the incidence of ventricular arrhythmias.
Results:
The comparison between initial and final evaluations, showed that there was a significant improvement of diastolic function (p = 0.04) and a trend to improvement of systolic function (great systolic volume and cardiac index) at EG. The incidence of non sustained ventricular tachycardia was the same in the two groups.
Conclusion:
In Chagas' disease enalapril improves significantly diastolic dysfunction in patients with heart failure. After two months of treatment we observed tendency to improvement of systolic dysfunction and the incidence of arrhythmias induced by stress test.