Left ventricular dysfunction: Effects of long-term enalapril therapy on remodeling

Doppler echocardiographic studies were carried out for 301 patients with left ventricular dysfunction who were randomized to placebo or enalapril so that a determination of the long-term effects of enalapril therapy on left ventricular structure and function could be made. Compared with placebo, enalapril resulted in a significant reduction in the mitral annular E-wave to A-wave velocity ratio, left ventricular end-diastolic and end-systolic volumes, left ventricular mass, and circumferential wall stress. Enalapril attenuated the remodeling process, which suggests that this mechanism is related to the beneficial effects of angiotensin-converting enzyme inhibitors on the clinical course of disease in patients with left ventricular dysfunction.