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Evaluation of enalapril+losartan treatment with cardiopulmonary exercise test in patients with left ventricular

Tamer Akbulut1, Haldun Akgöz, Sennur Unal Dayi

  • 1Siyami Ersek Cardiothoracic Surgical Center, Cardiology Clinic, Istanbul, Turkey.

Angiology
|March 7, 2006
PubMed

Insights

Adding losartan to enalapril significantly improved exercise capacity in patients with left ventricular systolic dysfunction. This combination therapy enhanced exercise duration and peak oxygen consumption, indicating better heart function.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Left ventricular systolic dysfunction (LVSD) is a condition characterized by impaired heart muscle contraction.
  • Standard treatment often involves ACE inhibitors like enalapril, but further improvements in exercise capacity are sought.

Purpose of the Study:

  • To evaluate the effects of adding losartan to enalapril in patients with LVSD.
  • To assess changes in exercise capacity using cardiopulmonary exercise testing (CPET).

Main Methods:

  • A study group (n=20) received enalapril plus losartan, while a control group (n=10) received enalapril alone.
  • Cardiopulmonary exercise testing (CPET) was performed before and after 6-8 weeks of treatment.
  • Key CPET parameters including exercise time, peak oxygen consumption (VO2), and anaerobic threshold VO2 were measured.

Main Results:

  • The enalapril-losartan group showed significant increases in average exercise times (p=0.001), peak VO2 (p=0.01), and anaerobic threshold VO2 (p=0.01).
  • At comparable exercise levels, the study group exhibited a reduced expired volume/oxygen consumption ratio (VE/VO2) (p=0.007) and lower heart rate (p=0.02).
  • No significant improvements were observed in the control group.

Conclusions:

  • Combination therapy with enalapril and losartan improves exercise capacity in patients with LVSD.
  • This combination leads to enhanced physiological efficiency during exercise, with lower heart rate and ventilation demands.
  • Losartan is a beneficial addition to standard ACE inhibitor therapy for managing LVSD.

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