Effects of Enalapril and Losartan in Left Ventricular Remodeling after Acute Myocardial Infarction: A Possible Mechanism of Prevention of Cardiac Events by Angiotensin-converting Enzyme Inhibitors and Angiotensin Receptor Blockers in High-risk Myocardial
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概要
- 論文の詳細を見る
Background Angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) have been shown to have a significant cardioprotective effect in high-risk patients after myocardial infarction (MI). However, there are few data on the effects of these drugs on left-ventricular (LV) remodeling after MI in Japanese patients. Methods and Results We randomly assigned 100 patients with anterior-wall MI who had received reperfusion therapy to treatment with either enalapril (n=50) or losartan (n=50), and calculated the LV ejection fraction (LVEF) and LV end-diastolic volume index (LVEDVI) in these patients at baseline and after 6 months of treatment. While a significant increase in the LVEF as compared with that at the baseline was observed in both groups, no significant difference was found in the rate of change of this parameter between the two groups. However, inverse correlations were observed between the baseline LVEF and LVEDVI and also the rates of change of the two parameters, suggesting that the greater the compromise of the LV function at baseline, the greater the preventive effect of both classes of drugs on LV remodeling. Conclusion The results of this study suggest that neither enalapril nor losartan is superior to the other in terms of the effect on LV remodeling after MI in Japanese patients. In addition, the suppressive effect of both classes of drugs on LV remodeling was greater in patients with more extensive infarction and greater compromise of LV function at baseline.
- 社団法人 日本内科学会の論文
著者
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HIRAYAMA Atsushi
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
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Nagao Ken
Department of Cardiology, Nihon University Surugadai Hospital
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Takahashi Hiroshi
Department of Cardiology, Nagoya Kyoritsu Hospital
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Tani Shigemasa
Departments of Cardiology
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Anazawa Takeo
Department of Cardiology, Nihon University Surugadai Hospital
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Kawamata Hirofumi
Department of Cardiology, Nihon University Surugadai Hospital
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Matsumoto Michiaki
Department of Cardiology, Surugadai Nihon University Hospital
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Kumabe Narimichi
Department of Cardiology, Nihon University Surugadai Hospital
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Iida Kiyoshi
Department of Cardiology, Nihon University Surugadai Hospital
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Onikura Motoyuki
Department of Cardiolugy, Nihon University Surugadai Hospital
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Furuya Shingo
Department of Cardiolugy, Nihon University Surugadai Hospital
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Kawamata Hirofumi
Department Of Cardiology Nihon University Surugadai Hospital
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Hirayama Atsushi
日本大学 医学部内科学系循環器内科
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Onikura Motoyuki
Department Of Cardiology Nihon University Surugadai Hospital
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Furuya Shingo
Department Of Cardiology Nihon University Surugadai Hospital
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Tani Shigemasa
Department Of Cardiology Nihon University School Of Medicine
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Kumabe Narimichi
Department Of Cardiology Nihon University Surugadai Hospital
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Iida Kiyoshi
Department Of Cardiology Nihon University Surugadai Hospital
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Matsumoto Michiaki
Department Of Applied Chemistry Oita University
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Anazawa Takeo
Department Of Cardiology Nihon University School Of Medicine
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Nagao Ken
Department Of Cardiology Cardiopulmonary Resuscitation And Emergency Cardiovascular Care Surugadai N
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Hirayama Atsushi
Division Of Cardiology Department Of Internal Medicine Nihon University School Of Medicine
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Takahashi Hiroshi
Department Of Applied Aquabiology National Fisheries University
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Matsumoto Michiaki
Department of Cardiology, Nihon University Surugadai Hospital
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