Reduction of exercise-induced ventricular arrhythmias in mild symptomatic heart failure by benazepril.
We studied 14 patients who had exercise-induced ventricular arrhythmias after a previous Q-wave myocardial infarction. All had symptomatic mild heart failure in New York Heart Association class II and a maximal oxygen consumption between 16 and 20 ml/kg/min. They were treated with the angiotensin converting enzyme inhibitor benazepril (20 mg) and hydrochlorothiazide (50 mg) for 3 months in a double-blind randomized cross-over study. Benazepril improved the maximal oxygen uptake by 15% and exercise time by 18%. Hydrochlorothiazide slightly increased exercise time (5%) and the respiratory exchange ratio but not oxygen consumption. The arrhythmias were nonsustained and reproducible in two baseline recordings. Compared with baseline, benazepril reduced the mean number (3.5 +/- 2.5) (+/- SD) of episodes of ventricular tachycardia by 66%, and total (47.4 +/- 40.9) and paired (5.2 +/- 4.5) premature ventricular contractions by 61% and 62%, respectively. Hydrochlorothiazide did not reduce the number of arrhythmias. Thus an improved cardiac function induced by benazepril is associated with a reduction in exercise-induced ventricular arrhythmias in patients with symptomatic mild heart failure after infarction.
Nordrehaug
J E
JE
Medical Department, Haukeland Hospital, University of Bergen, Norway.
Vollset
S E
SE
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D005117:Cardiac Complexes, Premature / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D015716:Electrocardiography, Ambulatory; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000517:prevention & control*
D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D006852:Hydrochlorothiazide; C044946:benazepril