Effects of high-dose lisinopril-isosorbide dinitrate on severe mitral regurgitation and heart failure remodeling

• Published in: The American journal of cardiology Vol. 82; no. 10; pp. 1299 - 1301
• Main Authors: Levine, Arlene B., Muller, Cynthia, Levine, T.Barry
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.11.1998; Elsevier; Elsevier Limited
• Subjects: Aged; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Biological and medical sciences; Cardiology; Cardiovascular disease; Cardiovascular system; Drugs; Female; Heart failure; Heart Failure - drug therapy; Hemodynamics - drug effects; Humans; Isosorbide Dinitrate - administration & dosage; Lisinopril - administration & dosage; Male; Medical research; Medical sciences; Middle Aged; Miscellaneous; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - drug therapy; Pharmacology. Drug treatments; Severity of Illness Index; Ultrasonography; Vasodilator Agents - administration & dosage; Ventricular Remodeling - drug effects; Human; Heart failure; Isosorbide dinitrate; Mitral valve; Lisinopril; Treatment efficiency; Cardiovascular disease; Left ventricle; Chemotherapy; Treatment; Cardiac valvular disease; Heart disease; Organic nitrate; Mitral regurgitation; Evolution; Combined treatment; High dose; ACE inhibitor
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(98)00623-7

Thus, in long-term, 1-year follow-up, uptitration of ACE inhibitor and nitrate therapy over established doses can further improve severe functional MR in patients with dilated cardiomyopathy due to a reversal of heart failure-related left ventricular remodeling. With marked left ventricular enlargement, >6.8 cm end-diastolic diameter, heart failure remodeling may be irreversible and resistant to further medical intervention.