Afterload reduction with captopril in chronic aortic regurgitation

ABSTRACT

The chronic hemodynamic effects of captopril were assessed in 22 asymptomatic patients with a moderate to severe isolated aortic regurgitation [AR] before and 3 months after administration of captopril [50-100 mg/day]. Supine heart rate decreased from 81.8 +/- 13.9 to 74.8 +/- 11.3 beats/min. [P <0.01], supine systolic blood pressure from 143.16 +/- 11.07 to 118.18 +/- 9.2 mmHg [P <0.001], mean wall stress from 796.77 +/- 162.78 to 655.6 +/- 148.69 Kdyn/cm2 [P <0.001] and septal thickness from 10.5 +/- 2.26 to 9.9 +/- 2.06 mm [P <0.05]. Left ventricular [LV] end-systolic and end-diastolic volumes, ejection fraction, shortening, fractional LV posterior wall thickness and LV mass did not change significantly. The degree of AR did not change significantly during the 3-month follow-up period. Captopril in a dose of 50-100 mg daily improves left ventricular afterload in asymptomatic patients with chronic AR, and a longer period of follow up is required to show its effect on LV mass and the severity of aortic regurgitation