Acute and long‐term effects of captopril on exercise cardiac performance and exercise capacity in congestive heart failure.
Why the study?
Does captopril improve haemodynamic measurements and exercise capacity in patients with stable congestive heart failure?
Population
15 patients with stable congestive heart failure
Comparison
Captopril treatment vs Baseline (before treatment)
Design
Cohort
Follow-up
3 months
Authors
Discussion
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Member takes
Implication
May support exercise gains with captopril in stable CHF; hypothesis-generating and should not change practice without RCTs.
Key Points
- To determine the acute and long-term hemodynamic effects and exercise tolerance changes produced by captopril at rest and during exercise in congestive heart failure.
- Assessed hemodynamic parameters at rest and during upright bicycle exercise before and during the initial two days of captopril administration in 15 patients with stable congestive heart failure.
- Performed repeat exercise cardiac catheterization after 3 months of maintenance captopril therapy in a subgroup of 6 patients.
- Acutely at rest, captopril reduced mean arterial pressure from 85 ± 9 to 64 ± 8 torr (p < 0.001) and left ventricular filling pressure from 26 ± 9 to 15 ± 7 torr (p < 0.001), while raising cardiac index from 2.0 ± 0.5 to 2.5 ± 0.6 L/min/m² (p < 0.001).
- During acute exercise, captopril significantly decreased maximum exercise heart rate (123 ± 15 to 115 ± 16 beats/min, p < 0.01), mean arterial pressure (93 ± 17 to 86 ± 14 torr, p < 0.05), and filling pressure (p < 0.001), though maximum cardiac index showed only a non-significant rise.
- After 3 months (N=6), maximum exercise cardiac index improved from 3.6 ± 0.7 to 4.6 ± 1.0 L/min/m² (p < 0.05), accompanied by increases in exercise duration (8.0 ± 2.2 to 11.5 ± 1.4 min, p < 0.05), workload (332 ± 32 to 468 ± 52 kpm/min, p < 0.05), and peak oxygen consumption (11.8 ± 2.6 to 15.6 ± 2.7 mL/min/kg, p < 0.05).
Structured PICO
Does captopril improve haemodynamic measurements and exercise capacity in patients with stable congestive heart failure?
P
Population
15 patients with stable congestive heart failure
I
Intervention
Captopril treatment (first two days for acute effects, 3 months for long-term effects)
C
Comparator
Baseline (before treatment)
O
Outcome
Haemodynamic measurements at rest and during upright bicycle exercisesurrogate
Captopril provides acute and long-term hemodynamic benefits at rest and during exercise, significantly increasing exercise capacity in patients with stable congestive heart failure.
Cite This Study
Krämer et al. (1982) studied this question.