Enalapril (10 mg/day) in systemic sclerosis. One year, double blind, randomised study (ESS-1): pulmonary substudy--effects of three month treatment.

The ESS-1 study is designed to evaluate the long-term effects of enalapril on cardiopulmonary system of patients with systemic sclerosis (SSc). During the one year study period 5 visits are scheduled at 3 months intervals. The effect of 3 months treatment with enalapril (10 mg per day) on lung function was studied in 18 patients with SSc (enalapril group) and compared with controls--23 patients with Ssc (placebo group), mean age, SSc duration, gender and % of patients with dcSSc did not differ significantly in both groups. We performed body plethysmography for total airways resistance (Rtot), and static lung volumes (TLC, ITGV and RV), spirometry for FEV1 and FVC and we measured flow parameters (PEF, FEF). We compared initial lung function (first examination) with results after 3 months treatment (second examination) in the enalapril and in the placebo group. Mean values of Rtot, ITGV and RV did not differ significantly in the enalapril group or in the placebo group before and after treatment but FVC, FEV1 and FEF50 were significantly lower in the enalapril group and did not change in the placebo group after three months. We conclude that 3 month treatment with enalapril worsens spirometry of SSc patients. We did not observe any changes in lung functions in the control group in the same three month period.

Enalapril (10 mg/day) in systemic sclerosis. One year, double blind, randomised study (ESS-1): echocardiographic substudy--three months follow-up.

The ESS-1 study was designed to evaluate the long-term effects of the angiotensin converting enzyme inhibitor (ACEI) enalapril (10 mg per day) on the cardio-pulmonary system in patients with scleroderma (SSc). We estimated changes in heart diameters, systolic and diastolic left ventricle function and mean values of pulmonary artery pressure after 3 months treatment. The study group comprise 41 patients with SSc. 18 patients received placebo and 23 ones were given enalapril. After 3 months of treatment we did not observe statistically significant differences in heart diameters and left ventricle systolic function parameters between treated group and placebo. Enalapril therapy did not affect left ventricle diastolic function, nevertheless differences in MVA were almost of statistical significance. Echocardiographic signs of pulmonary hypertension were found in 4 patients.

Enalapril (10 mg/day) in systemic sclerosis. One year, double blind, randomised study (ESS-1): ECG exercise testing--three months follow-up.

The ESS-1 study was designed to evaluate the long-term effects of the angiotensin-converting enzyme inhibitor (ACEI) enalapril (10 mg per day) on cardiopulmonary system of patients with systemic sclerosis (SSc). Exercise testing is used not only for estimation of coronary reserve but also physical capacity--the major determinant of quality of life. In each patient included to the ESS-1 study we performed ECG exercise test on treadmill (5 times at intervals of 3 months). The first follow-up was completed by 41 patients (23 patients in enalapril group and 18 in placebo group). The exercise duration in the placebo group was 683 +/- 295 sec and in enalapril group 768 +/- 173 sec. After 3 months of study there were no significant differences in both groups (758 +/- 271 sec and 720 +/- 191 sec respectively). The analysis of ST segment deviation did not provide any significant changes after 3 months of treatment. We conclude that 3 months enalapril treatment did not improve exercise tolerance in patients with systemic sclerosis.

[Multiple malformations syndrome: a case report]. / Zespól wad wrodzonych--opis przypadku.

We described a case with multiple congenital malformations diagnosed at 35 weeks of pregnancy by ultrasound examinations.