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Effect of angiotensin-converting enzyme inhibitor on cardiopulmonary baroreflex sensitivity in patients with acute myocardial infarction

      Neurohumoral excitatory state results from abnormality of baroreflexes and reduced tonic restraint of baroreflexes leads to neurohumoral excitation.
      • Abboud F.M.
      • Thames M.D.
      • Mark A.L.
      Role of cardiac afferent nerves in regulation of circulation during coronary occlusion and heart failure.
      The cardiopulmonary baroreflexes originate mainly from the heart
      • Grassi G.
      • Giannattasio C.
      • Cuspido C.
      • Bolla G.B.
      • Cleroux J.
      • Ferrazzi P.
      • Fiocchi R.
      • Mancia G.
      Cardiopulmonary receptor regulation of renin release.
      and modulate systemic vascular resistance, plasma catecholamines, and plasma renin activity.
      • Abboud F.M.
      • Eckberg D.L.
      • Johansen U.J.
      • Mark A.L.
      Carotid and cardiopulmonary baroreceptor control of splanchnic and forearm vasoconstrictor resistance during venous pooling in man.
      ,
      • Grassi G.
      • Gavazzi C.
      • Cesura M.
      • Picotti G.B.
      • Mancia G.
      Changes in plasma catecholamines in response to reflex modulation of sympathetic vasoconstrictor tone by cardiopulmonary receptors.
      Previous studies have reported that cardiopulmonary baroreflexes are depressed after acute myocardial infarction (AMI) and improve gradually from the initial impairment.
      • Mark A.L.
      • Mancia G.
      Cardiopulmonary baroreflexes in humans.
      ,
      • Grassi G.
      • Giannattasio C.
      • Seravalle G.
      • Osculati G.
      • Valagussa F.
      • Zanchetti A.
      • Mancia G.
      Cardiopulmonary receptor and arterial baroreceptor reflexes after acute myocardial infarction.
      Angiotensin-converting enzyme (ACE) inhibitors improve survival of AMI
      Acute infarction Ramipril Efficacy (AIRE) Study Investigators
      Effects of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure.
      ,
      Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
      GISSI-3 effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction.
      and have been shown to modify cardiopulmonary baroreflexes in patients with congestive heart failure.
      • Dibner-Dunlop M.E.
      • Smith M.L.
      • Kinugawa T.
      • Thames M.D.
      Enalaprilat augments arterial and cardiopulmonary baroreflex control of sympathetic nerve activity in patients with heart failure.
      However, the effect of ACE inhibitors on cardiopulmonary baroreflexes in patients with AMI is yet to be determined. Therefore, the present study was performed to evaluate the effect of the ACE inhibitor quinapril on cardiopulmonary baroreflexes in patients with AMI.
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