Effects of high-dose Lisinopril-isosorbide dinitrate on severe mitral regurgitation and heart failure remodeling

The systolic dysfunction in cardiomyopathy engen ders ventricular chamber dilation and increasing sphericity of the left ventricle.(1,2) This process of ventricular remodeling contributes to the development of functional mitral regurgitation (MR) in most patients with severe congestive heart failure.(3,5) It has long been recognized that vasodilator therapy can reduce the severity of functional MR in dilated cardiomyopathy by lowering ventricular afterload and improving forward how.(6-10) We have previously shown that, for heart failure patients stabilized on conventional doses of angiotensin-converting enzyme (ACE) inhibitor and nitrate therapy, further uptitration of vasodilator dosages may further improve left ventricular systolic function, increasing ventricular ejection fraction with a decrease in left ventricular size, a reduction in mitral regurgitation, and no change in measured systemic blood pressure.(11)