[Effect of treatment with vasodilators on physical exercise tolerance in patients with chronic congestive heart...

The studies were performed in 46 patients with chronic congestive heart failure (CCHF), III and IV NYHA classes. During the first two weeks all patients received digoxin (D) and furosemide (F) in optimal doses (stage O). Then, patients were randomly divided into two groups. During the stage A group I (n = 26) received digoxin, furosemide and nifedipine (N), while in the stage B captopril (K) was added to that treatment and it was continued for 4 weeks. During the following two weeks (stage C) patients were treated the same as in stage A. During the same stages group II (n = 20) received D, F and isosorbide dinitrate (S), then, D, F, S and K followed by D, F and S, respectively. After the termination of each stage of the treatment all patients performed physical exercise on bicycle ergometer, until limiting symptoms have occurred. Power (M) and duration (t) of exercise, systolic (ps) and diastolic (Pd) arterial blood pressures, heart rate (HR) at the peak load, and HR x Ps and HR/M indices were determined. It was found that N did not significantly affect the investigated ergometric parameters. Combined treatment with D, F, N and K induced an increase in M, t and HR, and a decrease in. This effect persisted through the stage C. Following the treatment with D, F and S, a significant increase in M and decrease in HR/M were observed. Addition of K to D, F, and S did not induce further improvement in the physical exercise tolerance of these patients.