Congestive Heart FailureComparison of Changes in Respiratory Function and Exercise Oxygen Uptake With Losartan Versus Enalapril in Congestive Heart Failure Secondary to Ischemic or Idiopathic Dilated Cardiomyopathy☆
Section snippets
Methods
This study was approved by the hospital ethics committee and all subjects gave written consent before starting the study.
Hemodynamics:
While on placebo, the ejection fraction was reduced by selection in the CHF group; blood pressure was also lower than in control subjects, possibly due in part to the inclusion in this group of some individuals with mild untreated hypertension. Enalapril, losartan, and aspirin (both alone and in combination) had no effect on blood pressure, heart rate, and ejection fraction in patients and controls.
Pulmonary Function:
As shown in Table I, forced expiratory volume in 1 second, maximum voluntary ventilation, forced
Discussion
Order or period effects were probably not a problem in the present study, because patients were randomized to receive preparations in different orders, treatments were separated by 3-week washout intervals, and patients in NYHA classes II to III have little change in exercise capacity and symptoms during treatment with placebo for up to 6 months.[19]
This crossover design study documented an equivalent efficacy of losartan and enalapril on VO2p, a parameter of significant prognostic value.20, 21
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This study was supported in part by a grant from the National Research Council, and the Monzino Foundation, Milan, Italy.