[Effect of captopril on the life expectancy of patients with chronic heart failure].
Since the introduction of vasodilator therapy, progress has been realized in the management of advanced congestive heart failure (CHF) of different etiologies. The most encouraging influences on hemodynamics, exercise tolerance and symptomatology have been reported with ACE-inhibitors. While hemodynamic parameters do correlate with prognosis in CHF [11, 14, 27], the overall prognosis in CHF is very poor [19], and there is no tight correlation between symptomatology, hemodynamics and prognosis [13]. A powerful influence of ACE-inhibitors has been demonstrated not only on hemodynamics and on the neuro-endocrine activation in CHF [10], but also on left ventricular hypertrophy [22] and myocardial morphology [16, 23]. On the background of these therapeutic options, we designed a double-blind, randomized, placebo controlled trial on the efficacy of captopril on mortality and morbidity in chronic CHF. The basic population studied consists of patients of a large community, university-affiliated hospital, with five sub-specialized divisions in internal medicine, and about 600 medical beds. All patients considered for participation live in the greater Munich area.


METHODS
With slight modifications, the criteria used in the Framingham Study were used as entrance criteria [19]. Patients were randomized if they were on stable therapy for their chronic congestive heart failure usually on digitalis and diuretics. Endpoints for the double-blind treatment period were either death or severe (with digitalis and diuretics) untractable heart failure NYHA Class IV. Follow-up examinations comprised office visits of the patients every three months for a precise cardiac history over the last three months based on a questionnaire. Captopril was used in a dose of 25 mg b.i.d.(ABSTRACT TRUNCATED AT 250 WORDS)
Kleber
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II. Medizinische Abteilung des Städtischen Krankenhauses München-Schwabing.
D002216:Captopril / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008017:Life Expectancy; D011897:Random Allocation
D002216:Captopril
Einfluss von Captopril auf die Lebenserwartung bei Patienten mit chronischer Herzinsuffizienz.