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ORIGINAL ARTICLE
Year : 2002  |  Volume : 3  |  Issue : 1  |  Page : 5

End-diastolic left ventricular pressure reduction in ischemic heart failure induced by Ramipril alone and Ramipril + Carvedilol: a Doppler-Echocardiographic study


Department of Internal Medicine, Second University of Naples, Naples, Italy

Correspondence Address:
Federico Cacciapuoti
Cattedra di Medicina Interna, Facoltą di Medicina e Chirurgia, Seconda Universitą di Napoli (S.U.N.), Piazza L. Miraglia, 280138-Napoli
Italy
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Source of Support: None, Conflict of Interest: None


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Method Thirty-four patients affected by Ischemic Heart Failure (IHF) were evaluated by Echocardiography (E). They had reduced Ejection Fraction % (EF%) evaluated by the cube volume-formula and evident from a decrease of V.max. of E wave and an increase of V. max. of A wave of mitral doppler inflow pattern, with reversal of E/A wave ratio. In addition, an increase of Iso-Volumic Relaxation Time (IVRT) and E wave Deceleration Time (DT) were present, while the pulmonary veins flow-pattern reflected increased End Diastolic Left Ventricular Pressure (EDLVP). Patients were treated with Ramipril (Group I) or Ramipril and Carvedilol (Group II). These drugs were given concommitant with other drugs (Digitalis, Diuretics, Antiplatelets and Nitrates). M-Mode and 2D-Echo were performed one week after the end of therapy. Result The echocardiographic parameters were evaluated in all patients at baseline and compared with those obtained respectively after Ramipril (Group I) and Ramipril + Carvedilol (Group II). Results showed a rise of LVESV and a decrease of LVEDV with progressive increase of EF% (from 30 to 40%). This change was also displayed by an increase of V. max. of E and a little decrease of A waves V. max. of mitral pattern (without inversion of their ratio in the Group I) and a similar but more evident change of V. max. of both waves, with reversal of E/A ratio in Group II. Conclusion: Ramipril, given with conventional drugs, resulted in poor reduction of EDLVP whereas the combination of Ramipril + Carvedilol added to conventional therapy, induced a more evident functional reduction of this hemodynamic parameter.


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