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Kim, Lee, Lee, Cho, Park, Seo, Suh, Yang, Yun, Cho, Lee, Kim, Kim, Sohn, Oh, and Park: Long-Term Effect of Angiotensin Converting Enzyme Inhibitor on Chronic Mitral Regurgitation
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Korean Circulation Journal

Korean Circulation Journal 2004; 34(2): 159-169.

Published online: 28 February 2004

DOI: https://doi.org/10.4070/kcj.2004.34.2.159

Long-Term Effect of Angiotensin Converting Enzyme Inhibitor on Chronic Mitral Regurgitation

Dae Hee Kim, Myung Mook Lee, Hae Young Lee, Hyun Jai Cho, Seung Jung Park, Jae Bin Seo, Jung Won Suh, Han Mo Yang, Chang Hwan Yun, Sang Ho Cho, Jun Hee Lee, Yong Jin Kim, Myoung A Kim, Dae Won Sohn, Byung Hee Oh, Young Bae Park

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Hanlym University College of Medicine, Seoul, Korea.

Copyright © 2004 The Korean Society of Circulation

Abstract

BACKGROUND AND OBJECTIVES: Angiotensin converting enzyme inhibitors (ACEI) have been suggested to be beneficial in regurgitant valvular heart disease by reducing both preload and afterload. Moreover their benefits have also been proven in acute mitral regurgitation (MR). However the role of long term administration of ACEI in chronic MR remains in dispute.
SUBJECTS AND METHODS: One hundred patients with more than moderate degree MR (rheumatic MR or Mitral valve prolapse [MVP] MR) were identified from patients undergoing cardiac echocardiography between April 1984 and July 2002. Patients with co-morbid valvular heart disease more than mild degree were excluded from the study. The subjects were divided into the study group (who took ACEI) and the control group. Medical records and echocardiographic reports were reviewed and the etiology of MR, left ventricular end-diastolic dimensions (LVEDD), end-systolic dimensions (LVESD), left atrial dimensions, and ejection fraction (EF) changes were studied serially for both groups.
RESULTS: The mean duration of follow-up was 5.0±3.2 years. There were no significant differences in age, blood pressure, or basal echocardiographic parameters between the rheumatic MR and MVP MR groups. In the MVP MR patients, the ACEI group showed a statistically significant increase in EF (p=0.007), decrease in LVESD (p=0.0014) and decrease in left atrial dimensions (p=0.01). However, in the rheumatic MR patients, the ACEI group showed no significant changes compared to those of the non-ACEI group.
CONCLUSION: Long term ACEI therapy seems to be beneficial in mildly symptomatic MR due to mitral valve prolapse.

Keywords: Mitral valve regurgitation, Mitral valve prolapse, Angiotensin-converting enzyme inhibitor

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