[Exercise capacity evaluation in patients with mild to moderate left ventricular dysfunction. Influence of captopril]

To analyse the captopril influence on physical activity on the six or nine minute walk test in patients with left ventricular dysfunction and mild or moderate failure.

Twenty one patients with functional class II or III heart failure and left ventricular diastolic diameter greater than 55 mm and with ejection fraction less than 45% were studied. Twelve were male, and the patients age range from 34 to 63 years old (mean 48 years). The protocol has 18 weeks of duration, the first two weeks constitute a washout period, and 16 of effective use of captopril 25 mg tid. The patients were submitted to clinical and laboratory evaluations, to echocardiogram study and six and nine minute walk test (distance of walk), before, through out, and after the protocol.

The distance of walk on six minute test were 451 m at the beginning, and 476 m in 4 weeks and 504 m at 16 weeks of treatment (p < 0.0001). At nine minute test it was respectively 599, 652 and 692 m (p < 0.001). The echocardiographic evaluation showed significative reduction of the left ventricular diastolic diameter and an increase of the left ventricular ejection fraction. The clinical evaluation after the treatment showed that 45% comes to functional class I, and only 10% stayed in class III.

Captopril 25 mg tid improves clinical performance significantly, with improvement of walk distance at six or nine minute of test, and with reduction of left ventricular end diastolic diameter and systolic function improvement. The results permits to conclude that captopril improves significantly the physical activity of patients with heart failure, this improves were observed with one months of therapy but is more evident with four months of effective treatment.