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OBJECTIVE This study attempted to evaluate the long-term efficacy of enalapril versus hydralazine therapy on left ventricular volume, mass and function as well as on the renin-angiotensin system in chronic asymptomatic aortic regurgitation. BACKGROUND We tested the hypothesis that early administration of a vasodilator drug might be able to reduce left ventricular dilation and mass expansion. Because the renin-angiotensin system may be activated in chronic aortic regurgitation, early enalapril therapy might be beneficial. METHODS Between 1990 and 1993, 76 asymptomatic nonrheumatic patients with mild to severe chronic aortic regurgitation were enrolled in a randomized, double-blind trial comparing enalapril with hydralazine. All patients underwent serial noninvasive studies. Seventy patients completed the 12-month follow-up. RESULTS At 1 year, patients receiving enalapril had a significant reduction in left ventricular end-diastolic and end-systolic volume indexes (124 +/- 15 vs. 108 +/- 17 ml/m2, p < 0.01; 50 +/- 12 vs. 40 +/- 14 ml/m2, p < 0.01, respectively) and mass index (131 +/- 16 vs. 113 +/- 19 g/m2, p < 0.01), whereas hydralazine therapy showed no significant changes. Both regimens not only had a significant reduction in left ventricular mean wall stress but also had a mild increase in exercise duration. Only enalapril therapy achieved a significant inhibition of the renin-angiotensin system, in contrast to hydralazine therapy. Moreover, the multiple r2 value from the analysis for end-diastolic volume index using the two variables of age and treatment drugs was 72.1% (p < 0.01). CONCLUSIONS Both regimens decrease left ventricular mean wall stress. Enalapril therapy achieves significant left ventricular mass regression, left ventricular end-diastolic and end-systolic volume index reduction and renin-angiotensin system suppression. These findings suggest that early unloading enalapril therapy has the potential to favorably influence the natural history of chronic aortic regurgitation.
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
August 1990,
Journal of the American College of Cardiology,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
September 2000,
The American journal of the medical sciences,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
December 2005,
Kardiologia polska,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
January 1978,
Kyobu geka. The Japanese journal of thoracic surgery,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
May 1986,
The American journal of cardiology,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
October 1991,
The American journal of cardiology,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
August 1985,
Revista medica de Chile,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
June 1997,
Chest,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
September 2011,
Expert review of cardiovascular therapy,
M Lin, and
H T Chiang, and
S L Lin, and
M S Chang, and
B N Chiang, and
H W Kuo, and
M D Cheitlin
April 2000,
American heart journal,
