Benefits of Enalapril on Doxorubicin-Related Ventricular Dysfunction Are Transient NEW YORK (Reuters Health) Dec 31 - For long-term survivors of childhood cancer treated with doxorubicin, the improvements in left ventricular (LV) function and structure at first seen with enalapril diminish over time, researchers report. Dr. Steven E. Lipshultz from the University of Rochester Medical Center, New York, and colleagues reviewed the records of 18 children who had been diagnosed with cancer at a mean age of 8 years and were treated with doxorubicin. These patients underwent regular echocardiography while receiving enalapril. The mean time between the completion of doxorubicin therapy and starting enalapril was 7 years and the median follow-up from the start of enalapril was 10 years, the researchers note. During the first 6 years of enalapril treatment, LV dimension, afterload, fractional shortening and mass all progressively improved toward normal values. However, from 6 to 10 years, all these markers deteriorated, Dr. Lipshultz's team reports. Throughout the study period, LV wall thickness, contractility and systolic blood pressure all deteriorated, and there was a slight decrease in diastolic blood pressure, they add. Of the six patients who had congestive heart failure at the start of enalapril treatment, all had died or undergone heart transplantation within 6 years. Among the 12 asymptomatic patients at the start of enalapril, only three had died or undergone heart transplantation, according to the report in the December issue of the Journal of Clinical Oncology. Dr. Lipshultz and colleagues conclude that "enalapril treatment produces a 6- to 10-year benefit before asymptomatic LV dysfunction returns to baseline and a 2- to 6-year benefit before medical management fails for patients with congestive heart failure." They add that "the primary defect, which is LV wall thinning, continues to deteriorate, and thus the short-term improvement was mostly related to lowered diastolic blood pressure." J Clin Oncol 2002;20:4517-4522. Thanks to Reuters Health Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.