[The cardioprotective action of captopril during atrial electrostimulation].

The presence of R-A-A system components in all organs (heart included) has suggested a possible cardio-protective effect of the angiotensin conversion enzyme inhibitors as a result of coronary flow improvement. This effect would act irrespective of the well-known peripheral vascular effects: vasodilation, blood pressure decrease, pre- and postload reduction. By using the atrial pacing in the quantitative assessment of the anginal threshold and of the associated ECG alterations before and after the i.v. administration of 25 mg of captopril we could immediately evaluate the coronary reserves by estimating the efficiency of captopril in the patients with angina pectoris. The atrial pacing has been performed, by using the method suggested by Sowton, in 18 patients with typical angina. The increase of heart tolerance at exercise, the systolic dynamics improvement and the ejection fraction increase as well as the raising of the anginal threshold have been noticed in 15 of the patients. The blood pressure has evidenced no significant changes. After the administration of captopril, the ischemic ECG alterations have been less marked and their postpacing remains shorter. Our findings plead for a direct action of captopril on cardiac intrinsic R-A-A system in the normotensive patients suffering from angina pectoris.