Influence of Perindopril on Left Ventricular Global Performance During the Early Phase of Inferior Acute Myocardial Infarction: Assessment by Tei Index

Abstract

Global LV function (DI) is impaired in patients with AMI-I. Administration of perindopril has a favorable impact on LV performance in patients with AMI-I, achieved through improvement of the diastolic function (IRT), which indirectly improves LV systolic function (ET, DI). This beneficial influence of perindopril is the result of the direct tissue effect of the drug and not its hemodynamic action.

Influence of Angiotensin II receptors blocking on overall left ventricle’s performance of patients with acute myocardial infarction of limited extent. Echocardiographic assessment

“…These data are consistent with the results of previous studies in AMI patients [22,23] or studies evaluating time intervals in MI [26,27]. Treatment with irbesartan induced significant shortening of isovolumetric contraction time and prolongation of ejection time.…”

“…Our results show that the treatment with Irbesartan likely resulted shortly to the restoration of global LV function after a first limited AMI. This latter finding is in accordance with recent studies [22,28] documenting the improvement of overall LV function in AMI patients with [28] or without [22] LV systolic dysfunction, after administration of either ACE inhibitors [22,28] or AT-1 receptors inhibitors [28]. It seems that independently from LV systolic function of AMI patients, blocking of harmfull effects of angiotensin II at any stage, possibly leads to a significant improvement of the global LV function.…”

“…Thus, we compared the standard echo Doppler parameters as well as the Tei index value in patients with AMI-I treated only with the conventional treatment, also in patients who additionally received Irbesartan and in age and gender matched healthy subjects. The isovolumetric relaxation time of patients with AMI-I was significantly longer than that of healthy subjects and is consistent with a previous study of our department [22], where a similar protocol was followed. On the other hand, Poulsen et al [23] reported no difference between the two groups concerning this time interval.…”

“…Taking into account that systolic blood pressure was not different between the patients groups, we could hypothesize that the observed benefit of Irbesartan derives from its direct tissue effect, irrespectively its hemodynamic action. These findings corroborate the results of our previous study with the ACE inhibitor perindopril in a similar population [22] and suggest that the inhibition at any point of renin-angiotensin system in patients with AMI and preserved systolic LV function, is not critically important in the regulation of water and sodium metabolism or the control of loading conditions (through circulating renin-angiotensin-aldosterone system). Instead, interaction with tissue renin-angiotensin and kinin/ kininases systems seems more relevant.…”

Coronary Ectasia Is Associated with Impaired Left Ventricular Myocardial Performance in Patients without Significant Coronary Artery Stenosis

“…Previous studies show that β-blockers, in addition to ACE inhibitors or ARBs, have beneficial effects on left ventricular remodeling [29]. Nearchou et al [30] reported that ACE inhibitor therapy improved ventricle performance and Tei index during the early phase of inferior acute myocardial infarction. However, in our study, there was no significant difference in the medications.…”