Heart 1997;78:537-538 ( December )
Editorial
Heart failure: vive la difference!
| The first 150 words of the full text of this article appear below. |
The clinical diagnosis of heart failure is independent of aetiology. Treatment strategies are aimed at alleviation of symptoms with diuretics and digoxin, and the improvement of cardiac function and prognosis with vasodilators and angiotensin converting enzyme (ACE) inhibitors. The impact of aetiology on management has largely been ignored. Recent clinical trials have indicated that patients with idiopathic dilated cardiomyopathy may respond differently from those with left ventricular dysfunction due to ischaemic heart disease.
ACE inhibitorsEarly studies of ACE inhibitors recruited patients according
to the severity of symptoms or degree of left ventricular dysfunction without specifying cause. However, two studies suggested that the
benefit of ACE inhibition was greater in patients with heart failure
caused by non-ischaemic cardiomyopathy. The Second Veteran's Cooperative Administration trial found a reduction in annual mortality rate to 14.1% in those with coronary artery disease and 10.7% in
those without underlying ischaemia when treated with
enalapril.1
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Drugs: cardiovascular system
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Dilated cardiomyopathy
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