Key result
Enalapril significantly improved exercise time (P<0.01), functional class, and maximum workload compared to placebo in patients with severe cardiac failure over 12 weeks.
Why the study?
Does enalapril improve functional capacity and exercise performance in ambulatory patients with severe heart failure receiving digoxin and diuretics?
RCT (n=12)
Double-blind
Parallel
Does enalapril improve functional capacity and exercise performance in ambulatory patients with severe heart failure receiving digoxin and diuretics?
Enalapril safely improves exercise capacity and preserves left ventricular ejection fraction in patients with severe heart failure already treated with digoxin and diuretics.
Supports adding enalapril to digoxin/diuretics for severe HF; extends ACEI evidence to exercise capacity in advanced disease.
The effects of the new, orally administered converting-enzyme inhibitor, enalapril (MK-421), were studied in 12 ambulatory patients with severe cardiac failure who were also receiving digoxin and diuretic agents. The study was double-blind, parallel, placebo-controlled and randomized. The clinical characteristics and pretreatment exercise performance were similar in the two groups of patients. All vasodilator drugs had been withdrawn two weeks before the start of the trial. At 12 weeks, the patients receiving enalapril showed a significant improvement in the functional class of the disease, exercise time (P less than 0.01), and maximum workload achieved, and experienced relief of symptoms. Blood pressure fell in patients receiving active treatment suggesting a reduction of afterload. Left ventricular ejection fraction was unchanged in enalapril-treated patients, but fell in patients on placebo (P less than 0.001). Enalapril was well tolerated without apparent adverse effects. It was effective when used with digoxin and diuretic agents in the treatment of severe cardiac failure, and its efficacy was maintained throughout 12 weeks of therapy.
No takes yet. Share an insight, caveat, or question.
Jennings et al. (1984) conducted an RCT in Severe congestive heart failure (n=12). Enalapril vs. Placebo was evaluated on Exercise time (p=<0.01). Enalapril significantly improved exercise time (P<0.01), functional class, and maximum workload compared to placebo in patients with severe cardiac failure over 12 weeks.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: