EFFECT OF CILAZAPRIL ON EXERCISE TOLERANCE IN CONGESTIVE-HEART-FAILURE

Cilazapril (C), an angiotensin-converting enzyme inhibitor with effective antihypertensive efficacy, was examined for its ability to alter exercise tolerance testing (ETT) and respiratory oxygen uptake in 33 patients with congestive heart failure (CHF). C was administered in capsules daily to patients with New York Heart Association Class II or Class III CHF for 12 weeks, in parallel double-blind treatment groups of 0 mg (n = 8), 0.5 mg (n = 8). 1.0 mg (n = 9), and 2.5 mg (n = 8). The blood pressure (BP) was reduced by 2.5 mg C: systolic BP (SBP) from 126 to 114 mm Hg, diastolic BP from 76 to 69 mm Hg. The maximum heart rate (MHR) during ETT was increased by 2.5 mg C from 137 to 143 bpm, as was the double product (MHR X maximum SBP X 0.01) from 237 to 251. There was an insignificant change in duration of exercise (548-610 s), anaerobic threshold (AT), and maximum oxygen uptake (14.1-15.7 ml/kg/min). The results suggest a positive effect of 2.5 mg C on energy utilization in CHF patients.