title: Angiotensin-converting enzyme inhibitor therapy improves respiratory muscle strength in patients with heart failure.
abstract: OBJECTIVE
  Respiratory muscle strength has been shown to be reduced in patients with chronic heart failure. The purpose of this prospective study was to determine whether long-term therapy with the angiotensin-converting enzyme (ACE) inhibitor perindopril improves respiratory muscle strength in patients with chronic heart failure.
  
  
  METHODS
  Eighteen patients with stable chronic heart failure were administered perindopril, 4 mg/d, in addition to their standard therapy for a period of 6 months. Fourteen patients completed the study. Maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax) expressed in percentage of predicted values, left ventricular ejection fraction (LVEF) determined by means of two-dimensional echocardiography, and pulmonary volumes were obtained before and after therapy.
  
  
  RESULTS
  As compared to baseline, there was a significant increase in both PImax and PEmax after therapy (57 +/- 27% predicted vs 78 +/- 36% predicted and 62 +/- 20% predicted vs 73 +/- 15% predicted, respectively; each p < 0.05). LVEF increased (34 +/- 5% vs 41 +/- 10%; p < 0.05); functional class improved by > or = 1 New York Heart Association (NYHA) class in five patients. There were no changes in pulmonary volumes. No correlation was found between changes in PImax and PEmax and changes in either LVEF or NYHA functional class.
  
  
  CONCLUSIONS
  In patients with chronic heart failure, long-term therapy with the ACE inhibitor perindopril improved respiratory muscle strength, as indicated by significant increases in PImax and PEmax.
authors.affiliation: U451 INSERM, Laboratoire d'Optique Appliquée-ENSTA-Ecole Polytechnique, Palaiseau, France. coirault@enstay.ensta.fr
authors.forename: C
authors.initials: C
authors.lastname: Coirault
authors.forename: A
authors.initials: A
authors.lastname: Hagège
authors.forename: D
authors.initials: D
authors.lastname: Chemla
authors.forename: M D
authors.initials: MD
authors.lastname: Fratacci
authors.forename: C
authors.initials: C
authors.lastname: Guérot
authors.forename: Y
authors.initials: Y
authors.lastname: Lecarpentier
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012132:Respiratory Muscles / Q000187:drug effects* / Q000502:physiology; D013318:Stroke Volume / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril