Angiotensin-converting enzyme (ACE) inhibition is indicated in all patients with ventricular dysfunction, whether asymptomatic (New York Heart Association [NYHA] class I) or symptomatic (NYHA classes II to IV). ACE inhibition delays progression to severe heart failure, decreases mortality and the frequency of hospitalization, enhances functional capacity and quality of life in symptomatic patients, and improves prognosis in asymptomatic patients with mild-to-moderate left ventricular dysfunction (ejec-
The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators.
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The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327:685-691.
Weber KT, Brilla CG. Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system. Circulation. 1991 ;83:1849-1865.
drug; ACEI; left ventricular dysfunction; remodeling; quality of life