Restoration of Cardiac Function and Structure by Converting Enzyme Inhibition Possibilities and Limitations of Long-Term Treatment in Hypertension and Heart Failure

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Abstract
(a) There is no doubt that cardiac function can be restored to a great degree in congestive heart failure treated with converting-enzyme inhibitors, but the mechanism of improvement involves the correction of peripheral abnormalities rather than a direct cardiac effect of the drug, (b) There is some evidence that deterioration of cardiac function and progressive cardiac dilation following myocardial infarction can be prevented by treatment with converting-enzyme inhibitors, (c) Regression of left ventricular hypertrophy (LVH) has been obtained by converting-enzyme inhibitors, both in man and in experimental animals. In animal studies, this regression of LVH was associated with restoration of contractile reserve and of coronary flow reserve to normal. The final significance of this restoration of structure and its functional aspects still needs further studies.

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