756-6 Effect of Long-term ACE-inhibitor Therapy in Hypertrophic Cardiomyopathy (HCM)

ACE-inhibitors (ACI) reduce left ventricular hypertrophy in patients with hypertension. There is experimental evidence that ACI may reduce nonhypertensive left ventricular hypertrophy. It was the goal of this study to investigate the effect of ACI therapy on left ventricular dimensions and exercise capacity in patients with HCM, 26 patients (P) with HCM were divided in two groups matched for age, sex and severity of disease. 13 P(group I: 2 f, 11 m, age 59±3.7 years) were treated with Ca-channel or beta-blockers. 13 P (group II: 2 f, 11 m, age 62±2.6 years) were additionally treated ‘with ACI (captopril 37,5 mg/d, enalapril 5-10mg/d). M-mode, 2-D and Doppler echocardiography as well as exercise tests were performed at the beginning (BEGIN) and at the end (END) of the observation period (group II 43±3 months, group II: 44±7 months). Septum and left ventricular posterior wall thickness (SEP, LVPW - mm), left atrial and left ventricular end diastolic diameter (LA, EDD - mml, intraventricular gradient (GRAD - mmHgl, duration (DUR - min,) and level (WATT-watt) of exercise were documented (Mean±SEM).SEPLVPWLAEDDGRADDURWAITGroup I:BEGIN20±1.313±0.646±2,647±1.732±55±0.498±9END18±1.312±0.747±2.747±2.742±125±0.394±8Group II:BEGIN:19±1.613±1.045±2.050±1.720±65±0.596±9END17±1.811±0,547±1.850±2.023±95±0.598±9ConclusionThere were no significant differences in left ventricular dimensions and exercise capacity between treated and untreated patients, In contrast to hypertensive left ventricular hypertrophy, non-hypertensive hypertrophic cardiomyopathy is not reduced by ACI