Follow-up of patients with chronic severe aortic regurgitation treated with ACE-inhibitor

Long-term treatment with ACE-inhibitors improves left ventricular function in patients with aortic regurgitation. But how does this advantage influence capacity? Using echocardiography and spiroergometry, we investigated 13 patients before and after a 3month treatment with cilazapril (2.5-5 mg/d). Ventricular enddiastolic diameter-index decreased from 3.5 to 3.1 cm/m(2) (p = 0.005), left ventricular endsystolic diameter-index from 2.3 to 2.0 cm/m(2) (p = 0.005), and wallstress from 174 to 150 dyn/cm(2) (p = 0.01). Left ventricular mass was reduced by 14 % to 488 g (= 253 g/m(2), p < 0.05). The regurgitant jet area decreased from 10.1 to 8.1 cm(2) (p < 0.05). Wall thickness, workload, and maximal oxygen intake showed no significant difference during follow-up. These results indicate that left ventricular volumes and muscle mass in patients with aortic regurgitation are positively influenced by long term ACE-inhibition, which preserves exercise capacity.