Circulation, Vol 70, 271-278, Copyright © 1984 by American Heart Association
DN Sharpe, J Murphy, R Coxon and SF Hannan
A number of studies have shown short-term hemodynamic and symptomatic
improvement in patients with congestive heart failure treated with
angiotensin converting-enzyme inhibitors. The long-term efficacy of the
oral long-acting converting-enzyme inhibitor enalapril remains to be
established in controlled studies. We evaluated this drug in 36 patients
with New York Heart Association functional class II to III heart failure
who were clinically stable on digoxin and diuretic therapy. After baseline
assessment of symptoms, exercise capacity, and results of echocardiographic
examination and right heart catheterization, patients were randomly
assigned to treatment with 5 mg enalapril twice daily (n = 18) or placebo
(n = 18) in a double-blind fashion. The two groups had similar clinical,
echocardiographic, and hemodynamic characteristics before treatment. After
3 months of treatment, the enalapril group showed a significant improvement
as judged by subjective patient impression, functional class, and exercise
duration (9.3 +/- 5.7 vs 17.6 +/- 5.6 min; p less than .001). Diuretic
dosage was reduced in six patients and increased in one patient, one
patient had died and another had been withdrawn from the study. In the
placebo group there was no significant change with respect to patient
impression, functional class, or exercise duration; diuretic dosage was
increased in seven patients and four patients had died. Echocardiographic
left ventricular dimensions were significantly reduced and left ventricular
shortening fraction significantly increased in the enalapril group but were
unchanged in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study
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