Effect of Angiotensin Converting Enzym Inhibition on Chronic Congestive Heart Failure Due to Coronary Artery Disease

Twenty patients with congestive heart failure caused by coronary heart disease (NYHA class III, IV) were studied. Study medication enalapril was administered randamly to twelve of them who had been already given digitalis and diuretics. Estimation of ventricular volumes were done before and five months after treatment. We measured also enddiastolic pressures and effort capacity of the patients before and after treatment. End systolic index was reduced significantly after treatment (88±25 ml/m2 to 81±28 ml/m2; p<0.05) for the enalapril group. We found lower enddiastolic pressure values for that group and their effort capacity was significantly higher after administration of enalapril (p<0.05). As with previous studies, this study showed that ACE inhibition can attenuate or even regress progressive dilation of the left ventricle after extensive transmural myocardial infarction and improve effort capacity and life quality. Enalapril was used at least 4 months after myocardial infarction (long after infarct healing) to a patient population with extremly dilated ventricles. We showed that desirable effects of ACE inhibition can be obtainable in such patients.