A meta-analysis of the effect of angiotensin-converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

被引:24
作者
Abdulla, J
Abildstrom, SZ
Christensen, E
Kober, L
Torp-Pedersen, C
机构
[1] Gentofte Univ Hosp, Dept Cardiol P, DK-2990 Hellerup, Denmark
[2] Bispebjerg Hosp, Dept Med 1, Copenhagen, Denmark
[3] Rigshosp, Ctr Heart, Dept Med, Div Cardiol B, Copenhagen, Denmark
[4] Bispebjerg Hosp, Dept Cardiol Y, Copenhagen, Denmark
关键词
angiotensin-converting enzyme inhibitor; congestive heart failure; exercise tolerance; exercise capacity; clinical trial;
D O I
10.1016/j.ejheart.2004.02.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To determine by meta-analysis whether angiotensin-converting enzyme (ACE) inhibitors improve exercise tolerance in patients with symptomatic left ventricular systolic dysfunction (LVSD). Methods and results: After literature search 13 multi-centre double blind parallel group trials that evaluated the effect of ACE inhibitors vs. placebo on exercise duration were selected. Ninety-four percent of patients were in New York Heart Association class II-IV The studies were combined using the Cochrane meta-analysis program (Review manager version 4.1). Analyses according to treatment period, exercise protocols and publication periods were performed. Treatment with ACE inhibitor over 4-12 weeks resulted in a beneficial effect on exercise duration (P= 0.003 and P= 0.0008 for 4- and 12-weeks treatment, respectively), but the magnitude of improvements did not exceed 30 s corresponding to only 5% compared with placebo. Conclusion: In addition to the pronounced effect on mortality and morbidity in patients with symptomatic LVSD, ACE inhibitors have improving effect on functional capacity measured as exercise tolerance time. (C) 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:927 / 935
页数:9
相关论文
共 62 条
[11]  
CLELAND JGF, 1984, BRIT HEART J, V52, P530
[12]  
CLELAND JGF, 1985, BRIT HEART J, V54, P305
[13]   COMPARATIVE EFFECTS OF IBOPAMINE AND CAPTOPRIL IN MILD CONGESTIVE-HEART-FAILURE - FOCUS ON THE LONG-TERM EFFECTS OF INODILATION ON VENTRICULAR ARRHYTHMIAS [J].
COCCHIERI, M ;
ALUNNI, GF ;
DELFAVERO, A ;
FORTUNATI, F ;
BARDELLI, G ;
CAPPONI, EA ;
REGI, L ;
BOSCHETTI, E .
CARDIOLOGY, 1990, 77 :36-42
[14]  
COHN JN, 1983, J AM COLL CARDIOL, V2, P755
[15]   EFFECTS OF ONCE-DAILY BENAZEPRIL THERAPY ON EXERCISE TOLERANCE AND MANIFESTATIONS OF CHRONIC CONGESTIVE-HEART-FAILURE [J].
COLFER, HT ;
RIBNER, HS ;
GRADMAN, A ;
HUGHES, CV ;
KAPOOR, A ;
LAIDLAW, JC .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (03) :354-358
[16]   A mechanistic investigation of ACE inhibitor dose effects on aerobic exercise capacity in heart failure patients [J].
Cooke, GA ;
Williams, SG ;
Marshall, P ;
Al-Timman, JK ;
Shelbourne, J ;
Wright, DJ ;
Tan, LB .
EUROPEAN HEART JOURNAL, 2002, 23 (17) :1360-1368
[17]   EFFECT OF CILAZAPRIL ON EXERCISE TOLERANCE IN CONGESTIVE-HEART-FAILURE [J].
CORDER, CN ;
RUBLER, S ;
DEERE, LF ;
PULS, A ;
PEGUERORIVERA, A ;
NAGARAJAN, R ;
HARWOOD, W .
PHARMACOLOGY, 1993, 46 (03) :148-154
[18]   EFFECT OF LONG-TERM ENALAPRIL THERAPY ON CARDIOPULMONARY EXERCISE PERFORMANCE IN MEN WITH MILD HEART-FAILURE AND PREVIOUS MYOCARDIAL-INFARCTION [J].
DICKSTEIN, K ;
BARVIK, S ;
AARSLAND, T .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (02) :596-602
[19]   INFLUENCE OF ANGIOTENSIN-CONVERTING ENZYME-INHIBITION ON EXERCISE PERFORMANCE AND CLINICAL SYMPTOMS IN CHRONIC HEART-FAILURE - A MULTICENTER, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL [J].
DOSSEGGER, L ;
ALDOR, E ;
BAIRD, MG ;
BRAUN, S ;
CLELAND, JGF ;
DONALDSON, R ;
JANSEN, LJ ;
JOY, MD ;
MARINNETO, JA ;
NOGUEIRA, E ;
STAHNKE, PL ;
STORM, T .
EUROPEAN HEART JOURNAL, 1993, 14 :18-23
[20]   CONTRASTING PERIPHERAL SHORT-TERM AND LONG-TERM EFFECTS OF CONVERTING ENZYME-INHIBITION IN PATIENTS WITH CONGESTIVE HEART-FAILURE - A DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL [J].
DREXLER, H ;
BANHARDT, U ;
MEINERTZ, T ;
WOLLSCHLAGER, H ;
LEHMANN, M ;
JUST, H .
CIRCULATION, 1989, 79 (03) :491-502