Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Short Communication

Volume 12, Number 6, December 2021, pages 363-368

Angiotensin-Converting Enzyme Inhibitor Therapy Effects in Patients With Heart Failure With Preserved and Mid-Range Ejection Fraction

**Table 1.** Baseline Characteristics
	HFpEF	HFmrEF	P-value
HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; NYHA: New York Heart Association; eGFR: estimated glomerular filtration rate; NT-proBNP: N-terminal prohormone of brain natriuretic peptide; LVEF: left ventricular ejection fraction; LAVI: left atrial volume index; LVEDV: left ventricular end-diastolic volume; LVEDD: left ventricular end-diastolic diameter; LVMI: left ventricular mass index; ACEI: angiotensin-converting enzyme; ARB: angiotensin II receptor blocker.
Age, years	66.5 (61 - 76)	68 (64- 77)	0.5
Sex, male, n (%)	18 (60)	23 (76.6)	0.09
Body mass index, kg/m²	32 (27.7 - 36.3)	29.6 (26.5 - 32.4)	0.06
NYHA, n (%)
II	14 (46.6)	9 (30)	0.3
III	16 (53.4)	21 (70)	0.3
Laboratory
Creatinin, mg/dL	1.09 (0.89 - 1.25)	1.07 (0.9 - 1.23)	0.9
eGFR, mL/min/1.73 m²	70 (51.4 - 97.1)	65.1 (50.5 - 88.4)	0.5
NT-proBNP, pg/mL	310 (250 - 372)	267 (226 - 361)	0.9
Echocardiographic parameters
LVEF, %	57 (55 - 59)	47 (45 - 48)	0.0000001
LAVI, mL/m²	36.6 (30.1 - 40.8)	40.1 (34.7 - 46.7)	0.08
LVEDV, mL	100 (82 - 114)	129.5 (98 - 150)	0.008
LVEDD, mm	50 (47 - 53)	54.5 (50 - 58)	0.002
LVMI, g/m²	115 (100 - 131)	112 (105 - 130)	0.7
Comorbidity, n (%)
Coronary artery disease	19 (63.3)	23 (76.6)	0.4
Myocardial infarction	8 (26.6)	17 (56.6)	0.03
Diabetes mellitus	20 (66.6)	24 (80)	0.4
Atrial fibrillation	8 (26.6)	15 (50)	0.1
Treatment, n (%)
ACEI other than perindopril	18 (60)	21 (70)	0.6
ARB	12 (40)	7 (23.3)	0.2
Diuretics	5 (16.6)	11 (36.6)	0.1

Table 1. Baseline Characteristics

HFpEF

HFmrEF

P-value

HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; NYHA: New York Heart Association; eGFR: estimated glomerular filtration rate; NT-proBNP: N-terminal prohormone of brain natriuretic peptide; LVEF: left ventricular ejection fraction; LAVI: left atrial volume index; LVEDV: left ventricular end-diastolic volume; LVEDD: left ventricular end-diastolic diameter; LVMI: left ventricular mass index; ACEI: angiotensin-converting enzyme; ARB: angiotensin II receptor blocker.

Age, years

66.5 (61 - 76)

68 (64- 77)

0.5

Sex, male, n (%)

18 (60)

23 (76.6)

0.09

Body mass index, kg/m²

32 (27.7 - 36.3)

29.6 (26.5 - 32.4)

0.06

NYHA, n (%)

14 (46.6)

9 (30)

0.3

III

16 (53.4)

21 (70)

0.3

Laboratory

Creatinin, mg/dL

1.09 (0.89 - 1.25)

1.07 (0.9 - 1.23)

0.9

eGFR, mL/min/1.73 m²

70 (51.4 - 97.1)

65.1 (50.5 - 88.4)

0.5

NT-proBNP, pg/mL

310 (250 - 372)

267 (226 - 361)

0.9

Echocardiographic parameters

LVEF, %

57 (55 - 59)

47 (45 - 48)

0.0000001

LAVI, mL/m²

36.6 (30.1 - 40.8)

40.1 (34.7 - 46.7)

0.08

LVEDV, mL

100 (82 - 114)

129.5 (98 - 150)

0.008

LVEDD, mm

50 (47 - 53)

54.5 (50 - 58)

0.002

LVMI, g/m²

115 (100 - 131)

112 (105 - 130)

0.7

Comorbidity, n (%)

Coronary artery disease

19 (63.3)

23 (76.6)

0.4

Myocardial infarction

8 (26.6)

17 (56.6)

0.03

Diabetes mellitus

20 (66.6)

24 (80)

0.4

Atrial fibrillation

8 (26.6)

15 (50)

0.1

Treatment, n (%)

ACEI other than perindopril

18 (60)

21 (70)

0.6

ARB

12 (40)

7 (23.3)

0.2

Diuretics

5 (16.6)

11 (36.6)

0.1

**Table 2.** Echocardiographic Parameters Before and After 12-Month Therapy With Perindopril
	Before perindopril prescription	After 12-month therapy with perindopril	P-value
HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; LAVI: left atrial volume index; LVMI: left ventricular mass index; LVEDD: left ventricular end-diastolic diameter; LVEDV: left ventricular end-diastolic volume; EF: ejection fraction.
HFpEF
LAVI, mL/m²	36.6 (30.1 - 40.8)	36.2 (30.2 - 41.8)	0.6
LVMI, mL/m²	115 (100 - 131)	114.8 (93.6 - 125.7)	0.04
LVEDD, mm	50 (47 - 53)	50 (47 - 52)	0.1
LVEDV, mL	100 (82 - 114)	98.5 (82 - 113)	0.02
EF, %	57 (55 - 59)	57.5 (56 - 59)	0.98
HFmrEF
LAVI, mL/m²	40.1 (34.7 - 46.7)	38.2 (34.5 - 46.5)	0.1
LVMI, mL/m²	112 (105 - 130)	113.1 (99.9 - 125.6)	0.008
LVEDD, mm	54.5 (50 - 58)	53.5 (49 - 57)	0.004
LVEDV, mL	129.5 (98 - 150)	121.5 (98 - 150)	0.001
EF, %	47 (45 - 48)	48 (46 - 50)	0.0002

Table 2. Echocardiographic Parameters Before and After 12-Month Therapy With Perindopril

Before perindopril prescription

After 12-month therapy with perindopril

P-value

HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; LAVI: left atrial volume index; LVMI: left ventricular mass index; LVEDD: left ventricular end-diastolic diameter; LVEDV: left ventricular end-diastolic volume; EF: ejection fraction.

HFpEF

LAVI, mL/m²

36.6 (30.1 - 40.8)

36.2 (30.2 - 41.8)

0.6

LVMI, mL/m²

115 (100 - 131)

114.8 (93.6 - 125.7)

0.04

LVEDD, mm

50 (47 - 53)

50 (47 - 52)

0.1

LVEDV, mL

100 (82 - 114)

98.5 (82 - 113)

0.02

EF, %

57 (55 - 59)

57.5 (56 - 59)

0.98

HFmrEF

LAVI, mL/m²

40.1 (34.7 - 46.7)

38.2 (34.5 - 46.5)

0.1

LVMI, mL/m²

112 (105 - 130)

113.1 (99.9 - 125.6)

0.008

LVEDD, mm

54.5 (50 - 58)

53.5 (49 - 57)

0.004

LVEDV, mL

129.5 (98 - 150)

121.5 (98 - 150)

0.001

EF, %

47 (45 - 48)

48 (46 - 50)

0.0002

**Table 3.** Endothelial Dysfunction and Myocardial Stretch Markers Before and After 12-Month Therapy With Perindopril
	Before perindopril prescription	After 12-month therapy with perindopril	P-value
HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; ET-1: endothelin-1; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.
HFpEF
E-selectin, ng/mL	57.25 (44.9 - 74.1)	46.05 (37.8 - 66.2)	0.000002
ET-1, pg/mL	0.99 (0.54 - 1.52)	0.76 (0.48 - 1.28)	0.00003
NT-proBNP, pg/mL	310 (250 - 372)	241.5 (193 - 300)	0.000002
HFmrEF
E-selectin, ng/mL	56.55 (34 - 64.2)	47.6 (30.2 - 54.3)	0.0003
ET-1, pg/mL	1.08 (0.79 - 1.48)	0.97 (0.65 - 1.22)	0.02
NT-proBNP, pg/mL	267 (226 - 361)	208 (174 - 286)	0.000002

Table 3. Endothelial Dysfunction and Myocardial Stretch Markers Before and After 12-Month Therapy With Perindopril

Before perindopril prescription

After 12-month therapy with perindopril

P-value

HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; ET-1: endothelin-1; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.

HFpEF

E-selectin, ng/mL

57.25 (44.9 - 74.1)

46.05 (37.8 - 66.2)

0.000002

ET-1, pg/mL

0.99 (0.54 - 1.52)

0.76 (0.48 - 1.28)

0.00003

NT-proBNP, pg/mL

310 (250 - 372)

241.5 (193 - 300)

0.000002

HFmrEF

E-selectin, ng/mL

56.55 (34 - 64.2)

47.6 (30.2 - 54.3)

0.0003

ET-1, pg/mL

1.08 (0.79 - 1.48)

0.97 (0.65 - 1.22)

0.02

NT-proBNP, pg/mL

267 (226 - 361)

208 (174 - 286)

0.000002