Enalapril (10Mg/Day) in Systemic Sclerosis
The ESS-1 study was designed to evaluate the long-term effects of enalapril (10mg per day) on the cardiopulmonary system of patients with systemic sclerosis (SSc). The 3 months follow-up was completed by 41 patients (23 patients in enalapril group and 18 in placebo group). We analysed conventional time domain signal averaged ECG (SAECG). Late potentials were considered to be present in QRS duration (QRS) was > 114ms or root mean square of last 40ms (RMS40) was < 20µV or terminal signal duration under 40µV (LAS40) was > 38ms at 40Hz. At the beginning of study the prevalence of abnormal SAEG parameters was similar in both groups. We observed one abnormal parameter among 13% of patients in enalapril group and 16.7% of patients in placebo group. There were 2 abnormal parameters in 26.1% of patients in enalapril group and 16.7% of patients in placebo group. After three months of treatment we did not find any patient with 2 parameters of late potentials in enalapril group and only 8.7% of patients with one such parameter. In placebo group no substantial improvement was observed.
Conclusion: The 3 months enalapril treatment seems to decrease the incidence of late potentials in patients with systemic sclerosis.
KeywordsPlacebo Group Systemic Sclerosis Late Potential Scleroderma Renal Crisis Enalapril Group
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- 1.LeRoy E C. Systemic Sclerosis. In: Wyngaarden JB, Smith LH Jr., eds. Cecil Textbook of Medicine. Philadelphia: WB Saunders. 2018–2033. 1988Google Scholar
- 7.Vacek JL, Handlin LR, Beaufort CJ, Koenig CA. Effects of angiotensin-converting enzyme inhibitor therapy on presence of late potentials detected using signal-averaged electrocardiography in patients with congestive heart failure. Coronary Artery Disease. 4:1109–1113. 1993.PubMedCrossRefGoogle Scholar
- 8.Gonzalez-Fernandez RA, Altieri Pl, Fernandez-Martinez J, Lugo JE. Reduction in cardiac conduction velocity delay by angiotensin converting enzyme inhibition in hypertensive patients with left ventricular hypertrophy. Detection by signal averaged electrocardiography. American Journal of Hypertension. 5:896–899. 1992.PubMedGoogle Scholar