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Effect of Captopril on Progressive Ventricular Dilatation after Anterior Myocardial Infarction
Abstract
We conducted a double-blind, placebo-controlled trial to determine whether ventricular dilatation continues during the late convalescent phase after myocardial infarction and whether therapy with captopril alters this process. Fifty-nine patients with a first anterior myocardial infarction and a radionuclide ejection fraction of 45 percent or less underwent cardiac catheterization 11 to 31 days after infarction, when they were not in overt congestive heart failure. They were randomly assigned to placebo or captopril and were followed for one year. A repeat catheterization was performed to evaluate interval changes in hemodynamic function and left ventricular volume. Thirty-eight male patients were evaluated with maximal-exercise treadmill tests every three months. No differences were detected at base line in clinical, hemodynamic, or quantitative ventriculographic variables. During one year of follow-up, the end-diastolic volume of the left ventricle increased by a mean [+/- SEM] of 21 +/- 8 ml (P less than 0.02) in the placebo group, but by only 10 +/- 6 ml (P not significant) in the captopril group. The left ventricular filling pressure remained elevated with placebo but decreased (P less than 0.01) with captopril. In a subset of 36 patients who were at high risk for ventricular enlargement because they had persistent occlusion of the left anterior descending coronary artery, captopril prevented further ventricular dilatation (P less than 0.05). Patients given captopril also had increased exercise capacity (P less than 0.05). This preliminary study indicates that after anterior myocardial infarction, ventricular enlargement is progressive and that captopril may attenuate this process, reduce filling pressures, and improve exercise tolerance.
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Cited by
Pfeffer, M. A., Braunwald, E., Moyé, L. A., Basta, L., Brown, E. J., Cuddy, T. E., Davis, B. R., Geltman, E. M., Goldman, S., Flaker, G. C., et al. (1992) · New England Journal of Medicine · doi:10.1056/nejm199209033271001 · Cited by 5,911
Self-citationHeidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922
(1992) · New England Journal of Medicine · doi:10.1056/nejm199209033271003 · Cited by 3,725
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.12.012 · Cited by 2,862
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Sadoshima, J.-I., Xu, Y., Slayter, H. S., & Izumo, S. (1993) · Cell · doi:10.1016/0092-8674(93)90541-w · Cited by 1,348
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Brown, N. J., & Vaughan, D. E. (1998) · Circulation · doi:10.1161/01.cir.97.14.1411 · Cited by 958
Self-citationOlivetti, G., Capasso, J. M., Sonnenblick, E. H., & Anversa, P. (1990) · Circulation Research · doi:10.1161/01.res.67.1.23 · Cited by 344
Konstam, M. A., Kronenberg, M. W., Rousseau, M. F., Udelson, J. E., Melin, J., Stewart, D., Dolan, N., Edens, T. R., Ahn, S., & Kinan, D. (1993) · Circulation · doi:10.1161/01.cir.88.5.2277 · Cited by 316
Duan, Q., McMahon, S., Anand, P., Shah, H., Thomas, S., Salunga, H. T., Huang, Y., Zhang, R., Sahadevan, A., Lemieux, M. E., et al. (2017) · Science Translational Medicine · doi:10.1126/scitranslmed.aah5084 · Cited by 262
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Hospital performance measures and 30-day readmission rates
Stefan, M. S., Pekow, P. S., Nsa, W., Priya, A., Miller, L. E., Bratzler, D. W., Rothberg, M. B., Goldberg, R. J., Baus, K., & Lindenauer, P. K. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2229-8 · Cited by 95
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Physiologic expansion of human heart-derived cells enhances therapeutic repair of injured myocardium
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Metadata
- Authors
- Pfeffer, M. A., Lamas, G. A., Vaughan, D. E., Parisi, A. F., & Braunwald, E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1988-07-14
- Volume
- 319
- Issue
- 2
- Pages
- 80-86
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2340149484
- Cited by
- 1,103
- References
- 0
- FWCI
- 61.45
- Type
- journal article
- Language
- en
- Open access
- closed
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