Short Term Evaluation of Captopril in Patients with Chronic Left Sided Valvular Regurgitations
KRIENGKRAI JIRASIRIROJANAKORN, M.D.*, NITHI MAHANONDA, M.D.**, PAYONK JOOTAR, M.D.*, SUPHACHAI CHAITHIRAPHAN, M.D.**, KANCHANA WANSANIT, R.N.**, WIPHAWIN WATANAPRAKARNCHAI, R.N.**
Affiliation : * Division of Cardiology, Department of Medicine, ** Her Majesty's Cardiac Centre, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Abstract Objective: To evaluate the clinical effects and the changes in cardiac performance of high- and low-dose captopril compared to placebo in patients with chronic symptomatic aortic regur- gitation (AR), and/or mitral regurgitation (MR). Patients and Methods: We randomized patients into three groups, placebo (Group 1), incre- mental daily doses of 50 mg (Group 2), and 100 mg captopril (Group 3). We compared exercise capacity before and after four-week of treatment. Results: Treatment was well tolerated with no serious side effects including blood chemistry. There were no significant effects of treatment on left ventricular dimensions nor cal- culated left ventricular ejection fraction (LVEF) between groups (LVEF change -0.6%, -2.6%, 2.4%, in group 1, 2 and 3 respectively; p > 0.05). No difference of exercise duration between treatment and placebo arms (change by 13%, 12.8%, 16.4%, respectively; p > 0.05). However, there were trends in the number of the patients who improved in left ventricular performance (absolute LVEF change > 5 % unit= 15%, 16%, and 42% respectively; p > 0.05) and exercise performance (exercise time improvement > 75 sec = 50%, 47%, and 68% respectively; p > 0.05) in high dose captopril treatment group. Conclusion: There was no significant improvement of left ventricular performance and exercise capacity after four-weeks' treatment of low and high dose captopril. Further study with a larger sample size, and longer follow-up period may be required.
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