To assess effects of enalapril and Accupro on clinical status left ventricular remodeling and systolic function in patients with heart failure due to dilated cardiomyopathy.
Study structure: Randomized, open, controlled, duration -- 6 months.
Patients: 31 patients with dilated cardiomyopathy (mean age 46+/-2 years).
Treatment groups: Standard therapy (glycosides, diuretics, peripheral vasodialtors) -- 9 patients. Standard therapy plus enalapril (10-20 mg/day) - 11 patients; standard therapy plus accupro (slow titration from 5 to a maximum 20 mg/day)-- 11 patients.
Criteria of evaluation: NyHa functional class, 6 -- minute wall test, echocardiographical parameters of left ventracular systolic function, while some parameters of remodeling deteriorated. Standard therapy did not change clinical status or left ventrical systolic function, while some parameters of remodeling deteriorated. Enalapril improved clinical status, left ventricular systolic function and affected favorably left ventricular remodeling. Accupro compared with enalapril produces greater influence on left ventricular remodeling. Our study suggests that intrinsic differences exist between quinaprilat and enalaprilat that determine the ability to improve endotelium vasodilation, their different affinity to tissue ACE.