The Effect of Enalapril on the Peak Rates of Left Ventricular Wall Movement in Patients with Dilated Cardiomyopathy / 대한내과학회지

OBJECTIVE: Angiotensin-converting enzyme inhibitors have been shown to improve survival in patients with congestive heart failure. To evaluate the efficacy of enalapril in patients with dilated cardiomyopathy during concurrent treatment with digoxin and diuretics, the peak rates of left ventricular movement were assessed after 6 months of follow-up by digitized echocardiography. METHODS: Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change (dD/dt) were obtained throughout the cardiac cycle. Normalized rates of wall movement (dD/dt/D) were used for comparison. RESULTS: 1) Compared with control subjects, patients with dilated cardiomyopathy showed much lower Peak(-) dD/dt and Peak(-) dD/dt/D. 2) Peak(+) dD/dt and Peak(+) dD/dt/D were also depressed in patients. 3) Peak dD/dt improved significantly (p<0.05) in the enalapril group (n=16), but did not change in the conventional treatment group (n=20) after 6 months. Peak dD/dt/D improved approximately (p<0.005) in the enalapril group. 5) There were no deaths in 2 treatment groups during initial 6 months, but 3 patients in the conventional treatment group died suddenly during 1 year of follow-up. CONCLUSION: The present study has shown that left ventrieular Peak dD/dt and Peak dD/dt/D are significantly depressed in patients with dilated cardiomyopathy. Enalapril appears to provide well-tolerated and effective long-term therapy by improving peak rates of left ventricular movement in patients with dilated cardiomyopathy.

A Study of Left Ventricular Function by Digitized Echocardiograms in Dilated Cardiomyopathy

Echocardiography provides a broad array of interrelated methods for the study of left ventricular structure and function. Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change could be obtained in patients with dilated cardiomyopathy. Peak dD/dT and peak dD/dT/D were significantly depressed in the patients. Normalized rates of systolic wall movement appear to be useful in detecting left ventricular disease because it reflect an increase in cavity size as much as any abnormality of contraction pattern. Digitized echocardiographic analysis may be one of good objective methods of evaluating the response to treatment in patients with various cardiac diseases.