[When does the treatment with captopril show a better improvement in physical performance in patients with heart failure?].
OBJECTIVE
Considering that heart failure reduces exercise capacity and that converting enzyme inhibitor increases this capacity, using the 6 min walk test we try to demonstrate when the treatment with captopril shows a better improvement in exercise capacity in patients with heart failure.


METHODS
Twenty one patients with functional class II or III heart failure (NYHA), left ventricular diastolic diameter greater than 55 mm and with ejection fraction less than 45% were studied. Twelve were male, and the patients mean age was 48 years. The patients were first treated with digital and diuretics and after stabilized they received captopril 25 mg three times a day and underwent the 6 min walk test before the treatment and after four and 16 weeks.


RESULTS
The use of captopril showed important improvement in exercise capacity in patients with heart failure. The mean walking distance on the 6 min test was 451 m at the beginning, 476 m in four weeks and 504 in 16 weeks of treatment (p < 0.0001).


CONCLUSIONS
Our data show important improvement in exercise capacity with 16 weeks of treatment and that 50% of this improvement occurred after four weeks of treatment. We concluded that the results are already observed within four weeks of treatment and continues to improve during at least four months of treatment.
Canesin
M F
MF
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo, Hospital São Lucas-PUC, Porto Alegre.
Barretto
A C
AC
Oliveira Júnior
M T
MT
Bodanese
L C
LC
Marafon
P
P
Arsencio
S R
SR
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D013318:Stroke Volume; D013997:Time Factors; D018754:Ventricular Dysfunction / Q000150:complications
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril