מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Ramipril causes regression of electrocardiographic signs of left ventricular hypertrophy (LVH), according to a report published in the October 2nd issue of Circulation. This effect is associated with an improvement in cardiovascular disease risk.
Dr. James Mathew, from the University of Iowa in Iowa City, and colleagues assessed the ECG patterns of high-risk cardiac patients who were randomized to receive ramipril or placebo. The study group included 676 patients with LVH at baseline and 7605 patients without LVH. The subjects were followed for 4.5 years.
By study end, 9.8% of placebo-treated patients had development or persistence of LVH compared with 8.1% of ramipril-treated patients. In contrast, 91.9% of ramipril-treated patients had regression or prevention of LVH, compared with 90.2% of patients in the placebo group (p = 0.007).
Ramipril's effects on LVH were independent of blood pressure changes, the authors note. Regression/prevention of LVH was associated with a reduced risk of death, myocardial infarction, stroke, and congestive heart failure.
In an editorial, Dr. Gregory Y. H. Lip, from City Hospital in Birmingham, UK, comments that "this study represents one of the first trials that convincingly shows that LVH regression really does matter, even in patients without hypertension."
Dr. Lip notes that "unfortunately, the study depends on ECG criteria of LVH, and it is certainly recognized that, although the ECG is a useful screening tool for LVH, it has a relatively low specificity and sensitivity."
However, he adds, "for now, the 12-lead ECG must be part of the routine evaluation of patients with vascular disease…because it is a simple, cost-effective" method of screening for LVH.
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