Effects of converting enzyme inhibition on baroreflex sensitivity in patients with myocardial infarction

Bonaduce, Domenico; Petretta, Mario; Morgano, G; Attisano, Tiziana; Bianchi, Valter; Arrichiello, P; Rotondi, Francesco; Condorelli, M

doi:10.1016/0735-1097(92)90012-c

Cited by 21 publications

(5 citation statements)

References 36 publications

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“…the diminished blood pressure variability may also play a role. Limitation of our study is that most of the patients in the acute MI group were receiving beta blocker and ACE inhibitor therapy, both group of medication has been known to affect heart period variability and baroreflex sensitivity [22,231. In wives of current therapeutic recommendations however omission of these drugs would rise serious ethical considerations.…”

Section: Discussionmentioning

confidence: 99%

Changes in Blood Pressure and Heart Period Variability in Patients with Recent Acute Myocardial Infarction

Kardos¹,

Halmai

Rudas

et al. 1996

Clinical Science

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1. A decreased heart period variability and baroreflex sensitivity in patients with acute myocardial infarction have already been documented. Since one of the major determinants of heart period variability is blood pressure variability, it would be important to know the characteristics of blood pressure regulation in this setting. The changes in blood pressure variability during the acute phase of myocardial infarction have not yet been studied. 2. We investigated the blood pressure variability and the heart period variability in 11 patients with acute myocardial infarction 3 to 5 days after their admission. Thirteen age matched patients with no evidence signs of ischaemic heart disease or previous myocardial infarction served as controls. We used the frequency domain indexes of short term measurements of finger blood pressure variability and heart period variability. The spectral powers for both heart period variability and blood pressure variability were divided into three major components: total frequency (0.01-0.4 Hz), low frequency (0.04-0.15 Hz) and high frequency (0.15-0.4 Hz). 3. All of the frequency-domain components of the heart period variability were significantly decreased in patients with recent acute myocardial infarction compared to the controls: Ln(total power): 5.68 +/- 0.24 vs. 7.21 +/- 0.29, Ln(low-frequency power): 4.31 +/- 0.28 vs. 7.05 +/- 0.53, Ln(high-frequency power): 3.50 +/- 0.33 vs. 5.48 +/- 0.32. Acute myocardial infarction patients showed a significantly reduced blood pressure variability in all frequency components compared to the controls: Ln(total power): 4.21 +/- 0.18 vs. 6.79 +/- 0.48, Ln(low-frequency power): 2.40 +/- 0.24 vs. 4.36 +/- 0.21, Ln(high-frequency power): 3.31 +/- 0.25 vs. 5.66 +/- 0.38. 4. We hypothesize that the reduced blood pressure variability in the acute phase of myocardial infarction could be related to a relative invariance of stroke volume. The underlying mechanism is the reduced left ventricular compliance.

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Section: Discussionmentioning

confidence: 99%

Changes in Blood Pressure and Heart Period Variability in Patients with Recent Acute Myocardial Infarction

Kardos¹,

Halmai

Rudas

et al. 1996

Clinical Science

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“…Angiotensin II facilitates the release of noradrenaline from sympathetic nerve terminals [24], and ACE inhibitors have been shown [[25-27]] to exert parasympathomimetic effects, to improve baroreflex sensitivity in patients after myocardial infarction [28] and to reduce sympathetic vasomotor tone in hypertensive patients [29]. Consequently, an ACE-inhibitor-induced reduction in sympathetic activity due to decreased levels of angiotensin II may, in the short term, contribute to a decrease in myocardial ischaemia.…”

Section: Discussionmentioning

confidence: 99%

No effects on myocardial ischaemia in patients with stable ischaemic heart disease after treatment with ramipril for 6 months

Willenheimer

Juul‐Möller

Forslund

et al. 2001

Trials

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“…Several reports have shown that angiotensinconverting enzyme inhibitors augment BRS, 43,44 and Ferrari et al reported that the administration of clinical doses of digitalis augmented BRS. 45 There have been conflicting reports about the effect of calcium antagonists on BRS; McLeay et al demonstrated that nifedipine increased sinoaortic baroreflex sensitivity in patients with essential hypertension, 46 but Giudicelli et al reported that diltiazem significantly reduced the tachycardic response to the bolus injection of nitroglycerin, suggesting that diltiazem might attenuate BRS.…”

Section: Study Limitationsmentioning

confidence: 99%

Correlation Between Atrial Natriuretic Peptide and Baroreflex Sensitivity in Patients With Congestive Heart Failure

et al. 1999

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Effects of converting enzyme inhibition on baroreflex sensitivity in patients with myocardial infarction

Abstract: This study demonstrates that in patients with uncomplicated myocardial infarction, captopril significantly improves the chronotropic response to baroreceptor stimulation.

Cited by 21 publications

References 36 publications

Changes in Blood Pressure and Heart Period Variability in Patients with Recent Acute Myocardial Infarction

Changes in Blood Pressure and Heart Period Variability in Patients with Recent Acute Myocardial Infarction

No effects on myocardial ischaemia in patients with stable ischaemic heart disease after treatment with ramipril for 6 months

Correlation Between Atrial Natriuretic Peptide and Baroreflex Sensitivity in Patients With Congestive Heart Failure

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