Effects of Long-term Enalapril Therapy on Cardiac Structure and Function in Patients With Left Ventricular Dysfunction

Greenberg, Barry; Quiñones, Miguel Á.; Koilpillai, Chris; Limacher, Marian C.; Shindler, Daniel M.; Benedict, Claude R.; Shelton, Brent J.

doi:10.1161/01.cir.91.10.2573

Cited by 426 publications

(211 citation statements)

References 34 publications

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“…12 For heart transplant recipients, baseline 2D echocardiograms of the donor heart were studied before explantation. For lung transplant recipients, the baseline echocardiogram was studied at the time of pretransplant evaluation.…”

Section: Measurements Of Left Ventricular Massmentioning

confidence: 99%

Cardiac hypertrophy after transplantation is associated with persistent expression of tumor necrosis factor-α

Stetson¹,

Perez‐Verdia²,

Mazur³

2002

ACC Current Journal Review

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Background-The mechanisms that contribute to cardiac allograft hypertrophy are not known; however, the rapid progression and severity of hypertrophy suggest that nonhemodynamic factors may play a contributory role. Tumor necrosis factor-␣ (TNF-␣) is a cytokine produced in cardiac allografts and capable of producing hypertrophy and fibrosis; therefore, we suggest that TNF-␣ may play a contributory role. Accordingly, the aims of our study were to define the role of systemic hypertension in the development of hypertrophy, characterize the histological determinants of hypertrophy, and characterize the expression of myocardial TNF-␣ after heart transplantation. Methods and Results-To separate the effect of hypertension from immune injury in the development of cardiac allograft hypertrophy, we measured the gain in left ventricular mass by 2D echocardiography in heart transplant recipients and lung transplant recipients who developed similar rates of systemic hypertension. The gain in left ventricular mass was 73% in heart transplant recipients and 7% in lung transplant recipients (PϽ0.0001). By comparing myocardial samples obtained during the first week after transplant and at 1 year, we found that there was a significant increase in total collagen content (PϽ0.0001), collagen I (PϽ0.0001), collagen III (PϽ0.0001), and myocyte size (PϽ0.0001). These changes were associated with persistent myocardial TNF-␣ expression. Conclusions-We suggest that the contribution of hypertension to cardiac allograft hypertrophy is minimal and that persistent intracardiac expression of TNF-␣ may contribute to the development of cardiac allograft hypertrophy.

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Section: Measurements Of Left Ventricular Massmentioning

confidence: 99%

Cardiac hypertrophy after transplantation is associated with persistent expression of tumor necrosis factor-α

Stetson¹,

Perez‐Verdia²,

Mazur³

2002

ACC Current Journal Review

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“…2 However, the mechanisms of LV remodeling or of the benefit of ACE inhibition remain to be elucidated.…”

mentioning

confidence: 99%

Activation of Matrix Metalloproteinases Precedes Left Ventricular Remodeling in Hypertensive Heart Failure Rats

et al. 2004

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Background-Matrix metalloproteinases (MMPs) are activated in dilated failing hearts, and angiotensin-converting enzyme (ACE) inhibition prevents left ventricular (LV) dilatation. However, it remains unclear whether activation of MMPs precedes or is secondary to LV remodeling, and an effect of ACE inhibition on MMPs is unknown. Methods and Results-Dahl salt-sensitive rats fed a high-salt diet from 8 weeks served as the hypertensive heart failure (HF) model. LV echo, histological study, measurement of mRNA levels, and gelatin zymography were performed before (at 23 weeks) and after (at 26 weeks) the development of LV dilatation and pulmonary edema. The same procedures were conducted in the HF model rats treated with a subdepressor dose of ACE inhibitor (enalapril 5 mg · kg Ϫ1 · d

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“…The addition of an aldosterone antagonist is recommended in patients with moderate to severe HF. In the SOLVD echo substudy 94 , Enalapril significantly reduced LV volumes and mass while Carvedilol decreased LV volumes and increased LVEF in the ANZ HF Collaborative Group 95 . The Val‐HeFT echo substudy 10 showed similar changes in LV dimension and LVEF with valsartan therapy.…”

Section: Role Of Echocardiography In Therapeutic Interventionmentioning

confidence: 95%

Echocardiographic evaluation of systolic heart failure

Thomas

2009

Australas J Ultrason Med

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Echocardiography is the most commonly used modality for evaluating left ventricular size and function in the context of systolic heart failure. Traditional techniques, though extensively used, have their limitations and more recently several newer technologies have emerged that are more reproducible, provide prognostic information, guide therapies and have an important role in monitoring progress. This review will evaluate the traditional and more novel techniques used and briefly provide an overview of the role of echocardiography in guiding and monitoring therapies in patients with systolic heart failure.

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Effects of Long-term Enalapril Therapy on Cardiac Structure and Function in Patients With Left Ventricular Dysfunction

Abstract: These data demonstrate that enalapril attenuates progressive increases in LV dilatation and hypertrophy in patients with LV dysfunction. The results support the possibility that the favorable effects of enalapril reported in the SOLVD trials were related to inhibition of LV remodeling.

Cited by 426 publications

References 34 publications

Cardiac hypertrophy after transplantation is associated with persistent expression of tumor necrosis factor-α

Cardiac hypertrophy after transplantation is associated with persistent expression of tumor necrosis factor-α

Activation of Matrix Metalloproteinases Precedes Left Ventricular Remodeling in Hypertensive Heart Failure Rats

Echocardiographic evaluation of systolic heart failure

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