Korean Circ J.  2004 Feb;34(2):159-169. 10.4070/kcj.2004.34.2.159.

Long-Term Effect of Angiotensin Converting Enzyme Inhibitor on Chronic Mitral Regurgitation

• Kim DH
• Lee MM
• Lee HY
• Cho HJ
• Park SJ
• Seo JB
• Suh JW
• Yang HM
• Yun CH
• Cho SH
• Lee JH
• Kim YJ
• Kim MA
• Sohn DW
• Oh BH
• Park YB

• KMID: 2227225
• DOI: http://doi.org/10.4070/kcj.2004.34.2.159

Abstract

BACKGROUND AND OBJECTIVES
Angiotensin converting enzyme inhibitors (ACEI) have been suggested to be beneficial in regurgitant valvular heart disease by reducing both preload and afterload. Moreover their benefits have also been proven in acute mitral regurgitation (MR). However the role of long term administration of ACEI in chronic MR remains in dispute.
SUBJECTS AND METHODS
One hundred patients with more than moderate degree MR (rheumatic MR or Mitral valve prolapse [MVP] MR) were identified from patients undergoing cardiac echocardiography between April 1984 and July 2002. Patients with co-morbid valvular heart disease more than mild degree were excluded from the study. The subjects were divided into the study group (who took ACEI) and the control group. Medical records and echocardiographic reports were reviewed and the etiology of MR, left ventricular end-diastolic dimensions (LVEDD), end-systolic dimensions (LVESD), left atrial dimensions, and ejection fraction (EF) changes were studied serially for both groups.
RESULTS
The mean duration of follow-up was 5.0+/-3.2 years. There were no significant differences in age, blood pressure, or basal echocardiographic parameters between the rheumatic MR and MVP MR groups. In the MVP MR patients, the ACEI group showed a statistically significant increase in EF (p=0.007), decrease in LVESD (p=0.0014) and decrease in left atrial dimensions (p=0.01). However, in the rheumatic MR patients, the ACEI group showed no significant changes compared to those of the non-ACEI group.
CONCLUSION
Long term ACEI therapy seems to be beneficial in mildly symptomatic MR due to mitral valve prolapse.

Keyword

Mitral valve regurgitation; Mitral valve prolapse; Angiotensin-converting enzyme inhibitor

MeSH Terms

Angiotensin-Converting Enzyme Inhibitors
Angiotensins*
Blood Pressure
Dissent and Disputes
Echocardiography
Follow-Up Studies
Heart Valve Diseases
Humans
Medical Records
Mitral Valve Insufficiency*
Mitral Valve Prolapse
Peptidyl-Dipeptidase A*
Angiotensin-Converting Enzyme Inhibitors
Angiotensins
Peptidyl-Dipeptidase A