QUANTIFICATION OF EXERCISE TOLERANCE IN CONGESTIVE HEART FAILURE AND ROLE OF ACE INHIBITORS

A prospective randomised controlled trial with captopril/enalapril was carried out on 25 patients with congestive heart failure (CHF) of various aetiologies in NYHA Class II & III to study the effect of Ace inhibitors on exercise tolerance. The control group (Gp-A) comprising of 12 patients received conventional treatment (digitalis and diuretics) and the test group (Gp-B) with 13 patients were in addition given captopril/enalapril as tolerated. They were followed up for a mean period of 101.6+50.6 days (approx 3 months). Ten patients from each group could complete the study. The exercise testing was done on treadmill using a suitable protocol and end-points, at the beginning and end of study. None of the clinical and noninvasive parameters showed significant difference, however the mean exercise duration in Group A improved from 7.84+3.34 to 9.2 +3.16 minute (P <0.05) and in Group B increased from 7.91+4.6 to 10. 92+4.66 minute (p < 0.001). On comparing the benefits of the two groups the difference was statistically significant (P < 0.05). It is concluded that Ace inhibitor improves the exercise tolerance in CHF and the benefit is evident despite any improvement in clinical and noninvasive indices of left ventricular function.