Cited by 316Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsRenin-Angiotensin System Studies

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Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction. SOLVD (Studies of Left Ventricular Dysfunction) Investigators.

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

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Abstract

BACKGROUND: Patients with heart failure and reduced left ventricular (LV) ejection fraction (EF) manifest progressive LV dilatation, which is prevented by angiotensin converting enzyme (ACE) inhibitors. In patients with asymptomatic LV systolic dysfunction, in whom there is less activation of the renin-angiotensin system, ventricular remodeling might be less rapid and the benefit of ACE inhibitors less discernible. METHODS AND RESULTS: One hundred eight patients enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) Prevention Trial, with left ventricular ejection fraction < or = 0.35 but without clinical heart failure, underwent radionuclide ventriculograms, and 49 underwent left heart catheterizations. Measurements were made before and after double-blinded randomization to enalapril (2.5 to 20 mg/d) or placebo. Repeated-measures analysis of all time points showed significant differences for change in end-diastolic volume (EDV) between enalapril and placebo groups. Significant difference between the enalapril and placebo groups (P < .05) was present for change in EDV at 1 year within the catheterization study and at a mean of 25 months within the radionuclide study. Radionuclide EDV increased in placebo patients (119 +/- 28 to 124 +/- 33 mL/m2, mean +/- SD) and decreased in enalapril patients (120 +/- 25 to 113 +/- 25 mL/m2). Differences between the two groups were significantly less than previously described in patients with symptomatic heart failure (P < .02), with less increase in LV volumes in the placebo group and less decrease in volumes in the enalapril group. CONCLUSIONS: Chronic ACE inhibitor treatment slows or reverses LV dilatation in patients with asymptomatic LV systolic dysfunction. Compared with symptomatic patients, asymptomatic patients manifest a slower rate of spontaneous LV dilatation and less reduction in LV volumes by enalapril.

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Authors: 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.
Affiliations: Tufts University (US)
ORCID: Konstam, M A
Kronenberg, M W
Udelson, J E
Stewart, D
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1993-11
Volume: 88
Issue: 5
Pages: 2277-2283
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.88.5.2277
OpenAlex: W1981884097
Cited by: 316
References: 22
Citations by year: 2026: 3 · 2025: 3 · 2024: 5 · 2023: 11 · 2022: 2 · 2021: 7 · 2020: 9 · 2019: 10 · 2018: 7 · 2017: 17 · 2016: 5 · 2015: 3 · 2014: 9 · 2013: 6 · 2012: 10
FWCI: 7.94
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hc055010-009)
National Heart, Lung, and Blood Institute (N01-HC-55010)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords: enalapril, ACE inhibitors, left ventricular dilatation, left ventricular systolic dysfunction, asymptomatic heart failure, ventricular remodeling, end-diastolic volume, left ventricular ejection fraction, renin-angiotensin system, heart failure prevention
MeSH terms: Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Blood Volume, Enalapril, Female, Cardiac Catheterization, Heart Diseases, Humans, Male, Middle Aged, Systole, Time Factors, Vasodilation, Radionuclide Ventriculography, Ventricular Function, Left

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Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction. SOLVD (Studies of Left Ventricular Dysfunction) Investigators.

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