Abnormal left ventricular systolic and diastolic functional response to isometric exercise in idiopathic dilated cardiomyopathy: beneficial effect of captopril.

In 19 patients with idiopathic dilated cardiomyopathy and symptoms of congestive heart failure, left ventricular (LV) systolic performance and diastolic velocity profiles were assessed by two- dimensional echocardiography and pulsed wave Doppler at rest and during handgrip exercise before and ninety minutes after administration of captopril (mean dose 25 +/- 12mg; range 12.5-50mg). Although heart rate and blood pressure increased similarly during handgrip exercise before and after captopril treatment, both were lower with handgrip exercise during captopril treatment. The results from this study indicated that acute angiotension converting enzyme inhibition with captopril reduces preload and afterload and ameliorates handgrip exercise-induced LV systolic and diastolic filling dysfunction in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy.