April 1, 1997Circulation
Improvement of Alveolar–Capillary Membrane Diffusing Capacity With Enalapril in Chronic Heart Failure and Counteracting Effect of Aspirin
Key result
Enalapril improved pulmonary diffusion and oxygen consumption in CHF patients (VO2 change correlated with DLCO change, r=0.80, P<0.0001), effects that were inhibited by aspirin.
Why the study?
Does enalapril improve pulmonary function and exercise capacity in patients with chronic heart failure, and is this effect counteracted by aspirin?
Population
16 patients with chronic heart failure and 16 normal volunteers or mild untreated hypertensives, plus 8…
Comparison
Enalapril, enalapril plus aspirin, or aspirin… vs Placebo for 15 days
Design
RCT, random order, double blind
Follow-up
15 days each treatment period
Authors
Discussion
Loading...
Member takes
Implication
ACE inhibitors enhance lung diffusion in CHF; extends their benefits beyond hemodynamics to gas exchange.
Key Points
- The study aims to evaluate the effects of enalapril on pulmonary function in chronic heart failure and the role of aspirin as a counteracting agent.
- 16 chronic heart failure patients and 16 control subjects underwent pulmonary function tests and exercise tests in a randomized, double-blind design.
- Participants received placebo, enalapril (10 mg BID), enalapril plus aspirin (325 mg/d), or aspirin over 15 days each.
- Pulmonary diffusion capacity (DLCO), oxygen consumption (VO2), and exercise tolerance were assessed.
- Enalapril significantly increased DLCO and VO2 in CHF patients (VO2 r = .80, P < .0001).
- Aspirin inhibited the effects of enalapril on pulmonary diffusion, representing a counteractive interaction.
- Hydralazine-isosorbide dinitrate reduced pulmonary capillary wedge pressure but did not impact DLCO or VE/VCO2.
Study Design
Type
RCT (n=40)
Blinding
double blind
Randomization
random order
Structured PICO
Does enalapril improve pulmonary function and exercise capacity in patients with chronic heart failure, and is this effect counteracted by aspirin?
P
Population
40 participants including 24 patients with chronic heart failure and 16 normal volunteers or mild untreated hypertensives, treated for 15 days per regimen.
I
Intervention
Enalapril (10 mg BID), enalapril plus aspirin (325 mg/d), or aspirin, for 15 days each (main study); hydralazine-isosorbide dinitrate (additional patients)
C
Comparator
Placebo for 15 days
O
Outcome
Pulmonary function and exercise tests with respiratory gas analysis (including pulmonary carbon monoxide diffusion [DLCO], oxygen consumption [VO2], exercise tolerance, VD/VT, and VE/VCO2)surrogate
Enalapril improves pulmonary diffusion and exercise capacity in chronic heart failure, an effect that is counteracted by aspirin, suggesting a prostaglandin-mediated mechanism.
Cite This Study
Guazzi et al. (1997) conducted an RCT in Chronic heart failure (n=40). Enalapril vs. Placebo, aspirin, or enalapril plus aspirin was evaluated on Pulmonary function and exercise tests with respiratory gas analysis (DLCO, VO2, VD/VT, VE/VCO2). Enalapril improved pulmonary diffusion and oxygen consumption in CHF patients (VO2 change correlated with DLCO change, r=0.80, P<0.0001), effects that were inhibited by aspirin.