Effect of Captopril on Left Ventricular Diastoli Function in Patients with Coronary Artery Disease

This placebo-controlled study was performed on 20 normal control subjects and 20 patients with coromary artery disease (CAD), and the effect of captopril, an angiotensin-converting inhibitor, on left ventricular diastolic function in patients with CAD was assessed by using pulsed Doppler echocardiography. In the patients, all cardioactive medications were stopped for 3 days, except for sublingual isosorbide dinitrate (if they expienced angina). Then, captopril or placebo was given to patients orally at a dose of 12.5 mg twice daily for a weck and in the following week, patients who had received placebo were given captopril. At the end of each period, patients were evaluated by physical examination and pulsed Doppler echocardiography. In contrast to the control group early, peak filling rate (E), late filling rate (A), E/A ratio acceleration half time (AHT), deceleration half time (DHT) and deceleration rate (DR) were all impaired in the patient group. When compared to placebo in the patient group, captopril caused a significant decrease in systolic and diastolic blood pressures and the double product, while it did not change heart rate significantly. Captopril also improved significantly in the patient group the LV parameters E, A, E/A ratio, DHT and DR. This study suggested that captopril significantly improved LV diastolic function in patients with CAD and that this improvement was due to a decrease in myocardial oxygen requirement and presumably to an increase in myocardial blod flow.