enalapril and Heart-Failure--Diastolic

Therapeutic efficiency of spirapryl and its combination with carvedilol in the treatment of diastolic cardiac insufficiency in patients with type 2 diabetes and essential arterial hypertension (AH). Criteria for inclusion in the study of 86 patients (20 men and 66 women) were diastolic cardiac insufficiency diagnosed as recommended by the Working Group of European Society of Cardiologists (2002). The patients were divided into 2 groups receiving either spirapryl (n = 42) or spirapryl with carvedilol (alpha, beta-adenoblocker). The patients were examined before and 24 weeks after therapy for the evaluation of their clinical condition, tolerance of physical activity, transmitral and transcuspidal diastolic flows (ECG and Doppler-ECG). All therapeutic modalities significantly improved the patients" conditions, diastolic function, and ECG/ECG characteristics, but the best results were obtained with combined therapy that had beneficial effect on transmitral and transcuspidal diastolic flows (P < 0.01) and tolerance of physical exercises (P < 0.05). It is concluded that combined treatment with spirapryl and its combination with carvedilol is more efficient for the management of diastolic cardiac insufficiency than carvedilol monotherapy.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Angiotensin-Converting Enzyme Inhibitors; Blood Glucose; Blood Pressure; Carbazoles; Carvedilol; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Drug Therapy, Combination; Echocardiography, Doppler, Color; Enalapril; Female; Follow-Up Studies; Heart Failure, Diastolic; Heart Ventricles; Humans; Hypertension; Male; Middle Aged; Propanolamines; Retrospective Studies; Treatment Outcome

Enalapril (average dose 7,0+/-0.8 mg) was given for 12 weeks to 15 patients with preserved left ventricular (LV) systolic function who had survived large focal myocardial infarction small i, Ukrainian6 months before that. The use of enalapril was associated with 49% lessening of severity of clinical signs of heart failure (p<0.001) and 47% increase of tolerance to physical exercise. It also provided dose dependent 17.8% reduction of LV myocardial mass (p<0.05), normalization of initially "hypertrophic" type of transmitral flow, 21% lowering of LV end diastolic pressure (p<0.05) without effect on LV volume, geometry, global and local systolic function.

Topics: Enalapril; Heart Failure; Heart Failure, Diastolic; Heart Ventricles; Humans; Ventricular Function, Left