[Effect of enalapril on restrictive type diastolic filling disorder in severe congestive heart failure]

Authors investigated the effect of enalapril (10-20 mg daily) on twenty-nine patients with chronic heart failure in NYHA III-IV stadium who's ejection fraction value was under 40% and had restrictive type of diastolic filling abnormality. Parameters of left ventricular function were measured by echocardiography and the basal data were compared to data detected at the time of 3 and 6 months control. A beneficial effect of enalapril was found on functional cardiac status (reduction in NYHA score), on systolic function (augmentation in ejection fraction and mean mitral anulus motion amplitude). Parallel with the previous parameters in the severity of restrictive diastolic filling alterations (reducing the value of pathologically high E/A ratio and an increasing in deceleration time of early diastolic filling wave) a countable decrease was observed. Authors emphasize the favourable effect of angiotensin converting enzyme inhibitors on chronic heart failure caused by different reasons independently of its severity. The source of drug action is reduction of the preload and afterload as well as keeping under control the harmful ventricular remodelling based on impediment of myocardial angiotensin system.