Objectives: To assess the effects of long-term angiotensin-converting enzyme (ACE) inhibitor treatment with captopril on cardiac function in acute myocardial infarction (AMI).
Methods: One hundred and one patients with AMI who were admitted to hospital within 72 hours of the onset of symptoms with no cardiogenic shock were randomly allocated to captopril (n = 52; group I) and conventional treatment (n = 49; group II). Left ventricular (LV) systolic performance and diastolic transmitral flow velocity profiles were assessed by Doppler echocardiography at admission (1.2 +/- 1.1 days), before discharge (27 +/- 10 days) and during follow-up (363 +/- 31 days).
Results: At one year follow-up, in group I LV end-diastolic volume decreased, and ejection fraction increased due to a disproportionate decrease in end-systolic volume. The incidence of cardiac dilatation was reduced. LV early diastolic filling velocity (E) increased and late atrial filling velocity (A) decreased, resulting in an elevation of E/A ratio. However, the mean values of LV systolic and diastolic functional parameters were unchanged in group II.
Conclusions: Long-term treatment with captopril exerts a beneficial effect on cardiac protection for patients with AMI.