Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions

Article Abstract:

Treatment with enalapril may prevent hospitalization for heart failure and increase survival of patients with asymptomatic left ventricular dysfunction. In patients with left ventricular dysfunction, the heart is unable to pump enough blood to the body. Of 4,228 patients with asymptomatic left ventricular dysfunction, 2,111 were treated with enalapril, and 2,117 received a placebo, an inactive substance. Treatment with enalapril decreased the risk of death by eight percent, and the risk of death from cardiovascular causes by 12%. Thirty percent of the patients in the the enalapril group developed heart failure or died, compared to 39% of those in the placebo group. Of all patients who developed heart failure, patients treated with enalapril developed heart failure after an average of 22 months, compared to an average of eight months for those who received a placebo. Twenty-one percent of the patients treated with enalapril died or were hospitalized for heart failure, compared with 25% of those who received a placebo.

Heart attack

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Incentive spirometry to prevent acute pulmonary complications in sickle cell diseases

Article Abstract:

Incentive spirometry may prevent lung collapse and the accumulation of fluid in the lungs of patients with sickle cell diseases and chest or back pain. Incentive spirometry measures the volume of breathed air while encouraging deeper breathing. During 38 hospitalizations, 29 patients with sickle cell diseases and chest or upper back pain either used or did not use an incentive spirometer. Collapsed lungs or fluid accumulation in the lungs occurred in only one of the 19 hospitalizations involving spirometry, but in 8 of the 19 hospitalizations without spirometry. Infarctions of the chest bones, in which a portion of a bone dies due to lack of blood, may cause lung collapse or fluid accumulation. Among patients who had chest bone infarctions, those who had spirometry were less likely than those who did not have spirometry to develop these lung complications.

Prevention, Lungs, Lung, Spirometry, Atelectasis

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Prevalence and pathologic features of sickle cell nephropathy and response to inhibition of angiotensin-converting enzyme

Article Abstract:

Kidney disease in sickle anemia patients may be caused by high blood pressure in blood vessels of the kidney. Of 381 patients with sickle cell disease, 26 patients (7%) had blood levels of creatinine (a component of urine) that were higher than normal, and 101 patients (26%) had proteinuria, or high levels of protein in their urine. Kidney biopsies from 10 sickle cell patients with proteinuria and kidney disease were compared to kidneys of patients without kidney disease. The patients with proteinuria had kidney lesions characterized by enlargement and thickening of blood vessels. The amount of protein excreted in the urine decreased in patients who were treated with enalapril, an ACE inhibitor. Enalapril may lower hypertension in kidney blood vessels.

Proteinuria

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