Document Detail

Early angiotensin converting enzyme inhibitor therapy after experimental myocardial infarction prevents left ventricular dilation by reducing infarct expansion: a possible mechanism of clinical benefits.
MedLine Citation:
PMID:  9894926     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the effects of early angiotensin-converting enzyme (ACE) inhibitor therapy after myocardial infarction on infarct expansion in an experimental rat model. BACKGROUND: ACE inhibitor therapy within 24 h of acute myocardial infarction (AMI) reduces mortality by unknown mechanism(s). METHODS: Rats underwent permanent coronary artery occlusion. A treated group received enalapril (1.9+/-0.2 mg/kg) daily in drinking water beginning 2 h after coronary artery occlusion, a time too late to reduce infarct size. Rats were sacrificed 2 days or 2 weeks after myocardial infarction. Hearts were arrested and fixed at a constant pressure, then sectioned and photographed for morphometric analysis. RESULTS: Infarcts in the control group expanded between 2 days and 2 weeks after myocardial infarction (expansion index 0.7+/-0.1 versus 2.5+/-0.4, P< 0.05). However, infarct expansion remained unchanged in the enalapril group between 2 days and 2 weeks after myocardial infarction (expansion index 0.8+/-0.1 versus 1.3+/-0.1, NS). Two weeks after myocardial infarction, the enalapril group had fewer expanded infarcts than the control group (expansion index 1.3+/-0.1 versus 2.5+/-0.4, P< 0.05). While left ventricular volume increased in the control group between 2 days and 2 weeks after myocardial infarction (0.17+/-0.01 ml versus 0.36+/-0.03 ml, P< 0.05), it remained constant in the enalapril group (0.22+/-0.02 ml versus 0.25+/-0.03 ml, NS). Two weeks after myocardial infarction, the left ventricles were larger in the control group than in the enalapril group (0.36+/-0.03 ml versus 0.25+/-0.03 ml, P< 0.05). CONCLUSIONS: Treatment with enalapril initiated 2 h after AMI prevented left ventricular dilation by limiting infarct expansion. This may explain the mechanism by which ACE inhibitor therapy started within 24 h of an AMI improves survival 5-6 weeks after infarction.
S M Ali; E J Brown; S R Nallapati; I A Alhaddad
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  9     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1998  
Date Detail:
Created Date:  1999-04-05     Completed Date:  1999-04-05     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  815-21     Citation Subset:  IM    
Department of Medicine, Bronx-Lebanon Hospital Center, New York 10457, USA.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Enalapril / therapeutic use*
Hypertrophy, Left Ventricular / prevention & control*
Myocardial Infarction / complications,  drug therapy*,  mortality
Random Allocation
Rats, Sprague-Dawley
Time Factors
Ventricular Remodeling / drug effects*
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 75847-73-3/Enalapril

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