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European Heart Journal 1998 19(12):1823-1828; doi:10.1053/euhj.1998.1241
Copyright © 1998 by the European Society of Cardiology.
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Failure of an ACE inhibitor to improve exercise tolerance. A randomized study of trandolapril

J.R. Hamptonaf1, A.J. Cowleya and A.M. Wnuk-Wojnarb

a Division of Cardiovascular Medicine, University Hospital, Queen’s Medical Centre, Nottingham, U.K.
b I Klinika Kardiologii Instytutu Kardiologii, Slaskiej Akademii Medycznej w Katowicach, Poland

accepted July 15, 1998

Background

There has been conflicting evidence of the effect of angiotensin-converting enzyme (ACE) inhibitors on exercise tolerance. Meta-analysis of published results has suggested that a beneficial effect of ACE inhibitors is demonstrated if a trial design is adequate.

Setting

Multicentre International Trial.

Methods

In a double-blind, randomized, multicentre trial, 292 patients with moderate (New York Heart Association Grades II and III) heart failure were treated with trandolapril or placebo in addition to diuretics, and followed for 16 weeks. Exercise tolerance on a treadmill was assessed at baseline and after 4, 8, 12 and 16 weeks of treatment. Both a modified Bruce and a modified Naughton protocol were used.

Results

Exercise tolerance improved in both treatment groups, with no significant benefit from trandolapril treatment.

Conclusion

Trandolapril does not improve exercise tolerance as measured by treadmill testing.

Key Words: ACE inhibitors • exercise duration • heart failure • trandolapril

f1 Correspondence: Professor J. R. Hampton, Division of Cardio-vascular Medicine, University Hospital, Queens Medical Centre, Nottingham NG7 2UH, U.K.


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