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Reduction of exercise-induced myocardial ischemia during add-on treatment with the angiotensin-converting enzyme inhibitor enalapril in patients with normal left ventricular function and optimal beta blockade
- Source :
- Journal of the American College of Cardiology, 37(2), 470-474. ELSEVIER SCIENCE INC
- Publication Year :
- 2001
- Publisher :
- Elsevier BV, 2001.
-
Abstract
- OBJECTIVES We sought to study the effect of angiotensin-converting enzyme inhibition on exercise-induced myocardial ischemia. BACKGROUND Although angiotensin-converting enzyme inhibitors have been shown to reduce ischemic events after myocardial infarction, few data are available regarding their direct anti-ischemic effects in patients with coronary artery disease. METHODS We studied 43 patients (average age 63 +/- 8 years) with exercise-induced myocardial ischemia (greater than or equal to0.1 mV ST depression, despite optimal beta blockade) and normal left ventricular function (ejection fraction >0.50). In a double-blind, placebo-controlled parallel design, patients were treated with angiotensin-converting enzyme inhibitor (enalapril 10 mg twice daily) or placebo. Assessments were made aii-er three weeks (short-term) and 12 weeks (long-term). RESULTS At baseline, the groups were well matched for all clinical characteristics. After three weeks, there was a slight but not significant increase in time to 0.1 mV ST depression in both groups (p = NS); rate pressure product (RPP = heart rate x systolic blood pressure) was also unaffected. After 12 weeks, however, time to 0.1 mV ST depression further increased in the enalapril group (5.6 +/- 1.9 min) but was unchanged in the placebo group (4.4 +/- 1.3 min; p
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Adrenergic beta-Antagonists
METOPROLOL
Angiotensin-Converting Enzyme Inhibitors
Coronary Disease
PECTORIS
Ventricular Function, Left
Angina Pectoris
Coronary artery disease
DOUBLE-BLIND
Electrocardiography
Double-Blind Method
Enalapril
Internal medicine
Humans
Medicine
Myocardial infarction
Aged
Metoprolol
Aged, 80 and over
ST depression
business.industry
Captopril
Middle Aged
medicine.disease
DYSFUNCTION
Treatment Outcome
Rate pressure product
CORONARY-ARTERY DISEASE
CHRONIC STABLE ANGINA
ACE inhibitor
Exercise Test
Cardiology
CAPTOPRIL
Drug Therapy, Combination
medicine.symptom
INFARCTION
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....fbdca1303e8372cb601c7c2e11931529