[Enalapril versus digoxin in chronic congestive cardiac failure. Study of variation of the left ventricular ejection fraction determined by radio-isotopic angioscintigraphy at rest and during exertion].
The effects of enalapril were evaluated in a double-blind, controlled study during 8 weeks, in patients with stable, congestive chronic cardiac insufficiency (functional classification II and III of the NYHA), in sinus rhythm, treated with digitalis and diuretics. 20 patients were randomly divided in two groups: one group continuing the digoxin (group A: 10 patients) and one group where enalapril was substituted for digoxin (group B: 10 patients). Patients from group B presented less clinical aggravation during the study. The left ventricular stroke volume (SV) is significantly decreased in group B at rest (0.21 +/- 0.06 at 50; 0.18 +/- 0.04 at 54; p less than 0.05), while it remained stable during stress. No variations of the SVs were noted at rest and during stress in group A. Considering its favorable clinical effects and after evaluation of its longterm side effects, enalapril may be an acceptable alternative to digitalis in cardiac insufficiency with sinus rhythm, except in patients for whom a drop in the systemic blood pressure or an increased kaliemia or creatininemia, could be potentially harmful.
Tissot
A
A
Centre de Médecine Nucléaire, Hôpital Cardiovasculaire et Pneumologique Louis-Pradel, Lyon.
Veillas
G
G
Lasne
Y
Y
Besson
J E
JE
D004077:Digoxin / Q000627:therapeutic use*; D004311:Double-Blind Method; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011875:Radionuclide Angiography; D011897:Random Allocation; D012146:Rest; D013318:Stroke Volume / Q000187:drug effects*
D004656:Enalapril; D004077:Digoxin
Enalapril versus digoxine dans l'insuffisance cardiaque chronique congestive. Etude de la variation de la fraction d'éjection ventriculaire gauche déterminée par angioscintigraphie radio-isotopique au repos et à l'effort.