AIMS:To study the effects of early use of enalapril on left ventricular function and exercise capacity after a first acute myocardial infarction, 356 patients without overt signs of congestive heart failure were randomly allocated to receive placebo or enalapril between days 7 and 14 after a first myocardial infarction. The study was conducted double-blind in 40 hospitals throughout Spain.

METHODS AND RESULTS:At baseline and after 26 weeks of follow-up exercise stress tests, Doppler-echocardiograms and isotopic ventriculography were performed in study participants. At the end of follow-up, patients in the enalapril group had lower end-systolic volume compared to those in the placebo group (55 vs. 62 ml; P=0.05). No difference in exercise capacity was evident between both groups.

CONCLUSION:The present study shows that enalapril therapy administered between 7 and 14 days after a first acute myocardial infarction decreases end-systolic volume and may inhibit the remodeling process of the left ventricle.

译文

AIMS :为了研究早期使用依那普利对首次急性心肌梗塞后左心室功能和运动能力的影响,随机分配356例无明显充血性心力衰竭迹象的患者接受安慰剂或依那普利第一次心肌梗塞后的第7天和第14天。该研究在西班牙的40所医院中进行了双盲研究。

方法和结果:在基线以及随访运动压力测试26周,多普勒超声心动图和同位素心室造影后在研究参与者中进行。随访结束时,依那普利组患者的收缩末期容积较安慰剂组低(55 vs. 62 ml; P = 0.05)。两组之间的运动能力无明显差异。

结论:本研究表明,在首次急性心肌梗死后7到14天之间服用依那普利治疗可减少收缩末期容积并可能抑制左心室的重塑过程。

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