title: Failure of protective effect of captopril and enalapril on exercise and dipyridamole-induced myocardial ischemia.
abstract: Fifteen patients with angiographic evidence of significant coronary artery disease, exertional myocardial ischemia, and positive dipyridamole echocardiographic test results at basal conditions and after 7 days of placebo treatment were prospectively studied to see whether captopril (containing sulfhydryl) and enalapril (nonsulfhydryl) modify myocardial ischemia induced by exercise testing and the effects of dipyridamole echocardiographic testing on regional myocardial contractility. Patients were randomized to captopril (150 mg/day in 3 separate doses) or enalapril (20 mg/day) for 1 week. At the end of this period each patient crossed over to the alternate regimen after a washout period of 7 days. Exercise stress testing and dipyridamole echocardiographic testing were repeated at the end of each treatment period. Neither captopril nor enalapril had a significantly greater anti-ischemic effect than placebo in any patient. Exercise duration, time to onset of ST-segment depression, maximal workload, degree of ST-segment depression, and rate-pressure product were not affected by either drug. Neither captopril nor enalapril improved dipyridamole-induced mechanical dysfunction or ST-segment depression.
authors.affiliation: Clinica del Lavoro Foundation Medical Center of Campoli Monte Taburno (BN), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Longobardi
authors.forename: N
authors.initials: N
authors.lastname: Ferrara
authors.forename: D
authors.initials: D
authors.lastname: Leosco
authors.forename: A
authors.initials: A
authors.lastname: Nicolino
authors.forename: D
authors.initials: D
authors.lastname: Acanfora
authors.forename: G
authors.initials: G
authors.lastname: Furgi
authors.forename: N
authors.initials: N
authors.lastname: Guerra
authors.forename: A
authors.initials: A
authors.lastname: Papa
authors.forename: P
authors.initials: P
authors.lastname: Abete
authors.forename: F
authors.initials: F
authors.lastname: Rengo
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002216:Captopril / Q000494:pharmacology / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004176:Dipyridamole; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods; D004656:Enalapril / Q000494:pharmacology / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D017211:Treatment Failure
chemical_list: D004176:Dipyridamole; D004656:Enalapril; D002216:Captopril