Angiotensin-converting enzyme inhibition and physical training in heart failure.
A total of 12 patients (mean age +/- SEM 63 +/- 2.6 years) with moderate to severe heart failure (ejection fraction = 23 +/- 3.2%) were included in a placebo-controlled crossover trial. Patients were randomly allocated to 4 periods of 6 weeks each: placebo, placebo and physical training, lisinopril 10 mg daily, and lisinopril and physical training. The exercise time increased from 13.6 +/- 0.9 min with placebo to 15 +/- 1 min with training alone, and to 16.1 +/- 0.7 min with lisinopril and training. With lisinopril alone there was a non-significant increase in exercise time, to 14.5 +/- 0.6 min. Improvements in exercise time were accompanied by a similar increase in peak oxygen consumption. Overall, the most significant improvements in symptoms and indices of cardiorespiratory fitness were achieved with a combination of lisinopril and training. Thus physical training is not only a useful adjunct to the existing medical therapy for heart failure, but it may also provide symptomatic benefits in its own right.
Meyer
T E
TE
Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK.
Casadei
B
B
Coats
A J
AJ
Davey
P P
PP
Adamopoulos
S
S
Radaelli
A
A
Conway
J
J
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004656:Enalapril / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017706:Lisinopril; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000187:drug effects / Q000502:physiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D017706:Lisinopril