Abstract: Atrial fibrillation (AF) is frequently encountered in patients with heart failure (HF) and is also a predictor of morbidity and mortality in this population. Recent experimental studies have shown electrical and structural atrial remodeling with increased fibrosis in HF animals, and have suggested a preventive effect of angiotensin converting enzyme inhibitors (ACEi) on the development of AF. To verify the hypothesis that ACEi prevent the development of AF in patients with HF, a retrospective analysis of the patients from the Montreal Heart Institute (MHI) included in the Studies Of Left Ventricular Dysfunction (SOLVD) was conducted. The results of this retroactive analysis indicate that treatment with the ACE inhibitor, such as enalapril, can markedly reduce the risk of developing atrial fibrillation in patients with left ventricular dysfunction.

Abstract: The present invention relates to the effect of angiotensin-converting enzyme (ACE) inhibitors on the prevention of diabetes in a subject with left ventricular dysfunction. A retrospective study was conducted to assess the effect of the ACE inhibitor enalapril on the incidence of diabetes in a group of patients from the Montreal Heart Institute enrolled in the Studies of Left Ventricular Dysfunction (SOLVD). Clinical charts were evaluated for fasting plasma glucose (FPG) levels by blinded reviewers. A diagnosis of diabetes was made when a FPG≧126 mg/dL (7 mmol/L) was found at 2 visits (follow-up, 2.9±1.0 years). Of the 291 non-diabetic patients enrolled in the SOLVD study, 153 of these were on enalapril and 138 were on placebo. Baseline characteristics were similar in the 2 groups. Forty patients developed diabetes during follow-up, 9 (5.9%) in the enalapril group and 31(22.4%) in the placebo group (P<0.0001).