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Effect of cilazapril on exercise tolerance in congestive heart failure

C N Corder1, S Rubler, L F Deere

  • 1Clinical Pharmacology, Department, Oklahoma Medical Research Foundation, Oklahoma City 73104.

Pharmacology
|January 1, 1993
PubMed

Insights

Cilazapril improved exercise capacity in patients with congestive heart failure (CHF). This angiotensin-converting enzyme inhibitor enhanced energy utilization and increased maximum heart rate during exercise tolerance testing.

Area of Science:

  • Cardiology
  • Pharmacology
  • Exercise Physiology

Background:

  • Congestive heart failure (CHF) significantly impairs exercise tolerance and quality of life.
  • Angiotensin-converting enzyme (ACE) inhibitors are standard therapy for CHF, but their impact on exercise parameters requires further investigation.

Purpose of the Study:

  • To evaluate the effects of Cilazapril (C), an ACE inhibitor, on exercise tolerance testing (ETT) and respiratory oxygen uptake in patients with CHF.
  • To determine the optimal dosage of Cilazapril for improving cardiovascular function in CHF patients.

Main Methods:

  • A 12-week, double-blind, placebo-controlled study involving 33 patients with New York Heart Association Class II or III CHF.
  • Patients received daily doses of Cilazapril (0 mg, 0.5 mg, 1.0 mg, or 2.5 mg).
  • Evaluated parameters included blood pressure, maximum heart rate (MHR), double product, exercise duration, anaerobic threshold (AT), and maximum oxygen uptake during ETT.

Main Results:

  • The 2.5 mg dose of Cilazapril significantly reduced systolic blood pressure (126 to 114 mm Hg) and diastolic blood pressure (76 to 69 mm Hg).
  • Maximum heart rate (MHR) increased from 137 to 143 bpm, and the double product (MHR x maximum SBP x 0.01) increased from 237 to 251 with the 2.5 mg dose.
  • No significant changes were observed in exercise duration, anaerobic threshold (AT), or maximum oxygen uptake (VO2 max).

Conclusions:

  • Cilazapril, particularly at a 2.5 mg dose, demonstrates a positive effect on energy utilization in CHF patients.
  • The findings suggest potential benefits of Cilazapril in improving cardiovascular response during exercise in heart failure.
  • Further research is warranted to explore the long-term effects and mechanisms of Cilazapril on exercise capacity in CHF.

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