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European Heart Journal 1993 14(5):692-695;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The Europen Society of Cardiology

Angiotensin converting enzyme inhibition at rest and during exercise in congestive heart failure

H. KELBÆK*, E. AGNER*, H. WROBLEWSKI*, P. VASEHUS MADSEN{dagger} and J. MARVING{dagger}

*Department of Cardiology, Rigshospitalet, Herlev Hospital, University of Copenhagen Denmark
{dagger}Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen Denmark

Received 15 June 1992; revised 1 October 1992; .

Correspondence Henning Kelbæk, MD, Department of Internal Medicine and Cardiology. Rigshospitalet B 2142. DK-2100 Copenhagen Ø, Denmark

Abstract

The haemodynamic effects of the sulfhydryl-containing angiotensin converting enzyme inhibitor, zofenopril, were studied in patients in New York Heart Association functional class II and III. Twenty-one clinically stable patients with coronary artery disease or cardiomyopathy completed a randomized double-blind treatment period of 2 months with either 15 mg zofenopril once daily or placebo. Regular therapy with digoxin and diuretic drugs was continued. Left ventricular volumes were measured by radionuclide angiography at rest and during submaximal bicycle exercise.

Zofenopril significantly increased mean stroke volume at rest from 59 to 67 ml (48 vs 48 ml in the control group, 95% confidence interval of the difference 1 to 16 ml) and left ventricular ejection fraction at rest from 39 to 43% (30 vs 30% in the control group, 95% confidence interval of the difference 1 to 8%). No significant changes occurred in heart rate, cardiac output, and blood pressure at rest, and zofenopril did not result in haemodynamic alterations during exercise.

Thus, 15 mg of the sulfhydryl-containing angiotensin converting enzyme inhibitor, zofenopril, administered once daily to patients with moderate heart failure increases left ventricular function at rest, but not during exercise.

Key Words: Angiotensin converting enzyme inhibition • left ventricular function • exercise • radionuclide cardiography


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