Therrien Judith, Provost Yves, Harrison Jeanine, Connelly Michael, Kaemmerer Harald, Webb Garry D
MAUDE Unit, Jewish General Hospital and McGill University Health Center, McGill University, Montreal, Quebec, Canada.
Int J Cardiol. 2008 Sep 26;129(2):187-92. doi: 10.1016/j.ijcard.2008.04.056. Epub 2008 Jul 30.
The effects of angiotensin converting enzyme inhibitor on systemic right ventricular size and function are unknown.
Prospective, double blind, randomized, placebo-controlled clinical trial of 1-year therapy with Ramipril in adult patients with DTGA status postatrial baffle procedure. Primary endpoints were change in systemic right ventricular ejection fraction (RVEF) and right ventricular size assessed by magnetic resonance imaging (MRI).
Seventeen patients were enrolled into the study. Mean age at study enrollment was 26.4+/-5.2 years. Mean baseline RVEF was 44+/-6.5%, mean RVEDV was 206.3+/-75.5 ml. Eight patients were randomized to the treatment group and 9 patients were randomized to the placebo group. RVEF did not improve in the Ramipril group from baseline to 1 year (43.8+/-7.1% vs. 40.9+/-13.3%, p=0.52) and remain unchanged in the placebo group (44.3+/-6.3 vs. 46.3+/-9.6%, p=0.42). RVEDV (184.5+/-56.4 ml vs. 179.6+/-66.4 ml, p=0.64) and RVESV (109.5+/-19.4 ml vs. 111.8+/-30.1, p=0.74) remained unchanged in the Ramipril group from baseline to 1 year as well as in the placebo group (228.1+/-89.2 ml vs. 204.5+/-50.4 ml, p=0.42 and 117.5+/-36.9 ml vs. 117.4+/-26.2 ml, p=0.99, respectively).
One-year treatment with Ramipril does not seem to affect right ventricular function or size in adult patients with systemic right ventricles after a Mustard or Senning procedure.
17 Adult patients (mean age of 26.4 +/- 5.2 years) with systemic right ventricles were blindly randomized to 1-year treatment with Ramipril placebo. Systemic right ventricular function (RVEF) and size (RVEDV) were assessed by magnetic resonance imaging at baseline and 1 year. RVEF failed to improve in the Ramipril group (43.8+/-7.1% vs. 40.9+/-13.3%, p=0.52) and remain unchanged in the placebo group (44.3+/-6.3 vs. 46.3+/-9.6%, p=0.42). RVEDV remained unchanged in the study group (184.5+/-56.4 ml vs. 179.6+/-66.4 ml, p=0.64 as well as in the placebo group (228.1 +/- 89.2 ml vs. 204.5 +/- 50.4 ml, p = 0.42). One-year treatment with Ramipril does not improve right ventricular function or attenuate remodeling in adult patients with systemic right ventricles.
血管紧张素转换酶抑制剂对系统性右心室大小和功能的影响尚不清楚。
对接受心房挡板手术后的完全性大动脉转位成年患者进行一项前瞻性、双盲、随机、安慰剂对照的临床试验，使用雷米普利进行为期1年的治疗。主要终点是通过磁共振成像（MRI）评估的系统性右心室射血分数（RVEF）变化和右心室大小。
17名患者被纳入研究。研究入组时的平均年龄为26.4±5.2岁。平均基线RVEF为44±6.5%，平均右心室舒张末期容积（RVEDV）为206.3±75.5ml。8名患者被随机分配到治疗组，9名患者被随机分配到安慰剂组。从基线到1年，雷米普利组的RVEF没有改善（43.8±7.1%对40.9±13.3%，p=0.52），安慰剂组也保持不变（44.3±6.3对46.3±9.6%，p=0.42）。从基线到1年，雷米普利组的RVEDV（184.5±56.4ml对179.6±66.4ml，p=0.64）和右心室收缩末期容积（RVESV）（109.5±19.4ml对111.8±30.1，p=0.74）保持不变，安慰剂组也是如此（228.1±89.2ml对204.5±50.4ml，p=0.42；117.5±36.9ml对117.4±26.2ml，p=0.99）。
对于接受Mustard或Senning手术后具有系统性右心室的成年患者，使用雷米普利进行一年治疗似乎不会影响右心室功能或大小。
17名具有系统性右心室的成年患者（平均年龄26.4±5.2岁）被随机分为接受雷米普利或安慰剂治疗1年。在基线和1年时通过磁共振成像评估系统性右心室功能（RVEF）和大小（RVEDV）。雷米普利组的RVEF没有改善（43.8±7.1%对40.9±13.3%，p=0.52），安慰剂组保持不变（44.3±6.3对46.3±9.6%，p=0.42）。研究组的RVEDV保持不变（184.5±56.4ml对179.6±66.4ml，p=0.64），安慰剂组也是如此（228.1±89.2ml对204.5±50.4ml，p=0.42）。雷米普利治疗一年并不能改善具有系统性右心室的成年患者的右心室功能或减轻重塑。
