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Scientific letters
Effects of combined treatment with enalapril and losartan on myocardial function in heart failure
  1. G Cocco,
  2. S Kohn,
  3. P Jerie
  1. Ita Wegman Clinic, Arlesheim, Switzerland
  1. Correspondence to:
    Giuseppe Cocco, MD, PO Box 119, Marktgasse 10A, CH-4310 Rheinfelden 1, Switzerland;
    gcocco{at}cocco.ch

https://doi.org/10.1136/heart.88.2.185

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    Recently published studies have shown than angiotensin converting enzyme inhibitors can be combined with angiotensin II antagonists and are highly effective in reducing mortality and improving the quality of life of patients with heart failure.1–3 There is little information about the effects of this combination on the myocardial function of patients with severe myocardial dysfunction. Thus, in 21 patients with stable heart failure of ischaemic aetiology, with New York Heart Association functional class III–IV and a resting left ventricular ejection fraction (EF) of ≤ 40%, who were treated with diuretics, β blockers, and/or digoxin (given at unchanged dosage), we studied the effects on myocardial dysfunction induced by adding either enalapril as a monotherapy, or the combination of enalapril and losartan.

    PATIENTS AND METHODS

    Patients were aged 50–75 years and gave their consent. The ethical committee approved the protocol. All patients underwent clinical routine examinations encompassing routine laboratory tests, ECGs, and colour Doppler transthoracic echocardiograms. The study was double blind, and double dummy and randomised (three parallel groups). Seven patients were treated with placebo (placebo + …

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