Skip Navigation

European Heart Journal 1993 14(Supplement C):18-23; doi:10.1093/eurheartj/14.suppl_C.18
Copyright © 1993 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Dössegger, L.
Right arrow Articles by Storm, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dössegger, L.
Right arrow Articles by Storm, T.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1993 The European Society of Cardiology

Influence of angiotensin converting enzyme inhibition on exercise performance and clinical symptoms in chronic heart failure: a multicentre, double-blind, placebo-controlled trial

L. Dössegger, E. Aldor*, M. G. Baird{dagger}, S. Braun{ddagger}, J. G. F. Cleland§, R. Donaldson||, L. J. Jansen, M. D. Joy**, J. A. Marin-Neto{dagger}{dagger}, E. Nogueira{ddagger}{ddagger}, P. L. Stahnke§§ and T. Storm||||

Clinical Research, Cardiovascular Division, F. Hoffmann-La Roche Ltd Basel, Switzerland
* Hanusch-Krankenhaus Vienna, Austria
{dagger} University of Ottawa Heart Institute Ontario, Canada
{ddagger} Ichilov Hospital Tel Aviv, Israel
§ Cardiology Unit, Hammersmith Hospital London, U.K.
|| National Heart Hospital London, U.K.
Bovenij Ziekenhuis Amsterdam, The Netherlands
** St. Peter's Hospital Surrey, U.K.
{dagger}{dagger} Hosp. Das Clinicas Da Faculdade De Medicina Ribeiraó Preto, Brazil
{ddagger}{ddagger} Hospital das Clinicas Cid. Universitária Zeferino Vaz, Campinas Brazil
§§ Praxis Schaeferkampallee Hamburg, Germany
|||| Sundby Hospital Copenhagen, Denmark

Correspondence: Dr. Lucette Dössegger, Clinical Research, Cardiovascular Div., F. Hoffmann-La Roche Ltd., Grenzacherstrase, CH 4002, Basel, Switzerland.

One hundred and seven patients with chronic heart failure (NYHA class II to IV) stabilized on digitalis and/or diuretics, recruited from 11 centres were randomized into a double-blind, placebo-controlled study to assess the effect of 12 weeks of cilazapril therapy on exercise tolerance and clinical status. Thirty-five patients were randomized to placebo and 72 to cilazapril at a starting dose of 1 mg daily; titration to cilazapril 2.5 mg at week 4 and 5 mg at week 8 (or matching placebo) was carried out in patients who did not improve clinically. Demographic characteristics, including exercise test duration increased from 402 s (±17 SEM) at baseline to 462 s (±19 SEM) at week 12 for the cilazapril group (+15%) and from 405 s (±23 SEM) at baseline to 408 s (±30 SEM) at week 12 in patients on placebo (+1%) (P < 0.001). In the placebo group, patients able to exercise for more than 6 min at baseline showed an increase in exercise duration at week 12 while those able to exercise for up to 6 min at baseline showed a decrease (P = ns). In contrast, cilazapril-treated patients showed an increase in exercise tolerance regardless of baseline exercise test duration; patients with the most impaired exercise tolerance at baseline showed a greater improvement than patients with mildly impaired baseline exercise tolerance (P < 0.05 vs placebo). NYHA class improved by at least one grade in 51% of the cilazapril group vs 32% in the placebo group (P = ns).

At the end of the trial, 15% of the patients were non-responders on cilazapril vs 41% on placebo (P < 0.01). A similar incidence of drop-out due to adverse events was observed in both groups (8.6% on placebo vs 8.3% on cilazapril) although adverse events were reported by fewer patients on placebo (17%) than on cilazapril (43%). Nine patients were withdrawn from the study for adverse events (three on placebo and six on cilazapril) and two patients died during the study (one in each group). Thus, in patients with chronic heart failure stabilized on digitalis and/or diuretics, angiotensin converting enzyme inhibition by cilazapril once a day was effective in prolonging exercise 'est duration, improving NYHA classification, heart failure signs and symptoms and was well-tolerated. This effect was greater in patients with the most impaired exercise tolerance at baseline.

Key Words: Cilazapril • chronic heart failure • exercise tolerance


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J Heart FailHome page
J. Abdulla, J. Pogue, S. Z. Abildstrom, L. Kober, E. Christensen, M. A. Pfeffer, S. Yusuf, and C. Torp-Pedersen
Effect of angiotensin-converting enzyme inhibition on functional class in patients with left ventricular systolic dysfunction--a meta-analysis
Eur J Heart Fail, January 1, 2006; 8(1): 90 - 96.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Heart FailHome page
J. Abdulla, S. Z. Abildstrom, E. Christensen, L. Kober, and C. Torp-Pedersen
A meta-analysis of the effect of angiotensin-converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction
Eur J Heart Fail, December 1, 2004; 6(7): 927 - 935.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.