Left ventricular (LV) dysfunction and decreased heart rate variabilty are independent predictors of mortality and it is unclear if there is a relationship between the two. ACE inhibitors have been shown to reduce the risk of morbidity and mortality in patients with heart failure. But the exact mechanisms involved are unknown. Effects on the autonomic nervous system and humoral balance are reflected in changes in heart rate variability.
Therapy with perindopril 2 mg/d appears to decrease sympathetic modulation of the heart, increase parasympathetic modulation of the heart, and improve LV function, all of which are prognostic factors in patients with HF (heart failure) after AMI.
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