The effects of
cilazapril on exercise tolerance and neurohumoral factors were investigated in old
myocardial infarction (OMI) patients with asymptomatic
heart failure and reduced left ventricular ejection fraction.
Cilazapril (0.5 mg) was administered once daily to OMI patients (n = 20) [NYHA class I, sinus rhythm, ejection fraction by
radionuclide scanning < 50% (36.8 +/- 9.1%, mean +/- SD)]. Two weeks later, five patients were excluded from the study because of
cough or
hypotension, and 15 patients received 1.0 mg
cilazapril once daily for the next 6 weeks. Exercise tolerance, neurohumoral factors and ejection fraction were measured in OMI patients before and after administration of
cilazapril. Seven age-matched healthy adults served as the controls. OMI patients had latent
heart failure because their exercise tolerance values and
aldosterone levels were lower and alpha-atrial natriuretic
polypeptide levels were higher than those in healthy subjects. In OMI patients, 8 weeks after
cilazapril administration, exercise duration increased from 545 +/- 59 to 590 +/- 74 sec (p < 0.05), anaerobic threshold from 17.5 +/- 3.2 to 20.1 +/- 2.8 ml/min/kg (p < 0.05), peak-VO2 from 23.5 +/- 4.7 to 27.1 +/- 4.4 ml/min/kg (p < 0.05), plasma
renin activity from 1.34 +/- 1.13 to 5.82 +/- 5.47 ng/ml/hr (p < 0.01) and alpha-atrial natriuretic
polypeptide decreased from 100.7 +/- 44.3 to 80.5 +/- 28.0 pg/ml (p < 0.05). In patients with asymptomatic
left ventricular dysfunction after
myocardial infarction, 8 week's
cilazapril administration improved exercise tolerance and neurohumoral conditions.