differential effects of the angiotensin-converting enzyme inhibitor lisinopril versus the beta-adrenergic receptor blocker atenolol on hemodynamics and left ventricular contractile function in experimental mitral regurgitation
Shintaro Nemoto, MD, PhD*,
Masayoshi Hamawaki, MD*,
Gilberto De Freitas, BS, BA* and
Blase A. Carabello, MD, FACC* ,*
* Department of Medicine, Division of Cardiology, Gazes Cardiac Research Institute, Medical University of South Carolina, Charleston, South Carolina, USA
the Ralph H. Johnson Department of Veterans Affairs, Charleston, South Carolina, USA
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Figure 1 Study protocol. MR = mitral regurgitation.
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Figure 2 Regurgitant fraction did not vary significantly over the course of this study and was consistently >50%. Lisinopril = angiotensin-converting enzyme inhibitor; Atenolol = beta-adrenergic receptor blocker; MR = mitral regurgitation.
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Figure 3 Left ventricular mass normalized for body weight increased significantly after three months of MR. During lisinopril therapy, it decreased insignificantly, but it was no longer greater than baseline. It increased again during the combined therapy and was significantly greater than baseline. Abbreviations as in Figure 2. ANOVA = analysis of variance.
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Figure 4 Forward stroke volume by thermodilution method was significantly depressed after three months of MR. Lisinopril increased it slightly. During the combined therapy, it rose significantly and returned to normal. Abbreviations as in Figures 2 and 3.
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Figure 5 End-systolic stiffness constant (K-index) was significantly depressed after three months of MR. It rose insignificantly on lisinopril therapy. Only when atenolol was added did contractility return to normal. Abbreviations as in Figures 2 and 3.
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