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Beneficial effects of one year captopril therapy on LV performance using echocardiographic parameters in children with asymptomatic chronic rheumatic aortic regurgitation.


Anna Luisa  A. de Jesus ,
Ma Lourdes S. Casas

Related Institution

Division of Pediatric Cardiology - Philippine Heart Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Cardiology
Publication Date
July-September 2000


BACKGROUND: This prospective study was designed to assess the effects of one year therapy of angiotensin converting enzyme inhibition with captopril in 88 children (mean age 14.4 +/- 2.74 years) with chronic asymptomatic rheumatic aortic regurgitation (AR). This research was performed to test the effect on LV performance of captopril with the use of echocardiographic parameters and its role in delaying the need for aortic valve replacement.

METHODS & RESULTS: After 12 months, patients receiving Captopril had a significant reduction in left end-diastolic (LVEDD) and end-systolic dimensions (LVESD), LV mass index, interventricular septum during diastole, diastolic and systolic LV posterior wall dimension, pulmonary artery pressure, end systolic wall stress, meridional wall stress and aortic regurgitation fraction. An increase in fractional shortening and ejection fraction were also noted with no significant change in the heart rate and blood pressure.

CONCLUSION: The usual dose of Captopril at 1-1.5 mg/kg/dose significantly reduced LVEDD and aortic regurgitation fraction. It produced a significant change in the pre and afterload parameters without associated symptoms of secondary adrenergic system activation such as sinus tachycardia or hypotension. Acute positive hemodynamic effects were confirmed by the result of one-year therapy with significant reduction in left vetricular volume overload. These suggest the possibility that therapy with ACE inhibitors can prolong asymptomatic AR course and delay the need for aortic valve replacement. (Author)

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Philippine Council for Health Research and Development Fulltext Print Format
Philippine Council for Health Research and Development Fulltext pdf (Request Document)

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