Document Detail

Effects of long-term therapy with enalapril on severity of functional mitral regurgitation in dogs with moderate heart failure.
MedLine Citation:
PMID:  7860927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study examined the effects of early long-term monotherapy with enalapril on the severity of functional mitral regurgitation in dogs with moderate heart failure. BACKGROUND: Functional mitral regurgitation often develops in patients with heart failure and, depending on its severity, can have a marked adverse impact on the stroke output of the failing left ventricle and contribute to progressive deterioration of the heart failure state. METHODS: Left ventricular dysfunction (ejection fraction 30% to 40%) was produced in 14 dogs by multiple sequential intracoronary microembolizations. Dogs were randomized to 3 months of therapy with enalapril (10 mg twice daily, n = 7) or no therapy at all (control, n = 7). The severity of functional mitral regurgitation was quantified by Doppler color flow mapping in seven control and six enalapril-treated dogs. Mitral annular diameter was assessed by echocardiography and left ventricular volumes and shape by ventriculography. Measurements were made before initiation and after completion of therapy. RESULTS: In control dogs, the severity of mitral regurgitation increased during the follow-up period ([mean +/- SEM] 14 +/- 4 vs. 23 +/- 4%, p < 0.001) and was associated with increased left ventricular end-systolic and end-diastolic volumes. In contrast, the severity of regurgitation was not significantly changed in dogs treated with enalapril (18 +/- 3 vs. 16 +/- 6%, p < 0.59) and was associated with preservation of left ventricular volumes. CONCLUSIONS: In dogs with moderate heart failure, early long-term therapy with enalapril prevents progressive worsening of functional mitral regurgitation. This beneficial effect is most likely achieved by prevention of progressive left ventricular dilation.
H Shimoyama; H N Sabbah; H Rosman; T Kono; M Alam; S Goldstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  25     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-03-23     Completed Date:  1995-03-23     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  768-72     Citation Subset:  AIM; IM    
Department of Medicine, Henry Ford Heart and Vascular Institute, Detroit, Michigan.
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MeSH Terms
Cardiac Output, Low / complications*,  pathology,  ultrasonography
Dilatation, Pathologic
Disease Progression
Echocardiography, Doppler
Enalapril / pharmacology,  therapeutic use*
Mitral Valve Insufficiency / complications,  drug therapy*,  pathology,  ultrasonography
Myocardium / pathology
Treatment Outcome
Ventricular Function, Left / drug effects
Grant Support
Reg. No./Substance:

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