title: Captopril reduces the VE/VCO2 ratio in myocardial infarction patients with low ejection fraction.
abstract: OBJECTIVE
  To determine whether captopril (CAP) therapy had an effect on the minute ventilation/carbon dioxide output (VE/VCO2) ratio at submaximal levels of exercise in asymptomatic patients with reduced left ventricular function after myocardial infarction.
  
  
  METHODS
  Double blinded, randomized, prospective, repeated measures.
  
  
  METHODS
  One hundred thirty-five patients with left ventricular ejection fractions of < 40% were randomly assigned to a treatment group (CAP; n = 62) or a placebo group (PLC; n = 73). Subjects had cycle ergometer exercise tests at 2 to 6 months (T1), 10 to 14 months (T2), and > 22 months (T3) postmyocardial infarction.
  
  
  METHODS
  Oxygen uptake (VO2), VCO2, and VE were measured throughout each exercise test. Dependent variables were peak VO2 (VO2peak), the ventilatory anaerobic threshold (VAT), and the VE/VCO2 ratio measured at 30 W and at 75% VO2peak.
  
  
  RESULTS
  VO2peak and VAT did not differ as a result of treatment (CAP vs PLC; p = 0.92 and 0.80) or over time (T1 vs T2 vs T3; p = 0.51 and 0.07). VE/VCO2 was significantly lower for CAP at 30 W (p = 0.05) and, although lower at 75% VO2peak, did not obtain statistical significance (p = 0.22). The between group differences were larger at T2 and T3 when compared with T1.
  
  
  CONCLUSIONS
  CAP resulted in a reduced VE/VCO2 ratio during submaximal exercise. The reduced ventilation may permit patients to perform their normal activities of daily living at a lower perception of difficulty, reduce symptoms, and provide an improved quality of life.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, PA 17822-2160, USA. tmcconnell@psghs.edu
authors.forename: T R
authors.initials: TR
authors.lastname: McConnell
authors.forename: F J
authors.initials: FJ
authors.lastname: Menapace
authors.forename: L H
authors.initials: LH
authors.lastname: Hartley
authors.forename: M A
authors.initials: MA
authors.lastname: Pfeffer
mesh_terms: D015308:Anaerobic Threshold; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D002216:Captopril / Q000494:pharmacology*; D002245:Carbon Dioxide / Q000502:physiology*; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D010101:Oxygen Consumption / Q000187:drug effects; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D012123:Pulmonary Ventilation / Q000187:drug effects*; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002245:Carbon Dioxide; D002216:Captopril