AN OPEN-LABEL, UNCONTROLLED TRIAL OF THE ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR CILAZAPRIL IN THE TREATMENT OF PATIENTS WITH CHRONIC CONGESTIVE-HEART-FAILURE

We assessed cilazapril, an angiotensin-converting enzyme (ACE) inhibit or, in the treatment of patients with chronic congestive heart failure . A single 2.5-mg dose of cilazapril was given to 20 patients with chr onic congestive heart failure rated as New York Heart Association func tional Class II for 15 days according to our protocol. Exercise capaci ty, breath-by-breath oxygen analysis, and echocardiographic variables were assessed before and after treatment. Cilazapril improved peak exe rcise time statistically significantly (7.36 +/- 3.48 minutes vs 9.45 +/- 4.17 minutes), but peak oxygen consumption (17.45 +/- 4.19 mL/kg p er minute vs 18.65 +/- 3.70 mL/kg per minute) and peak heart rate (145 .5 +/- 23.7 beats/min vs 149.9 +/- 27.1 beats/min) did not increase si gnificantly. Anaerobic threshold time (3.31 +/- 2.38 minutes vs 4.64 /- 2.99 minutes), anaerobic threshold oxygen consumption (11.03 +/- 2. 52 mL/kg per minute vs 12.77 +/- 2.92 mL/kg per minute), and anaerobic threshold ratio (63.35 +/- 7.59% vs 68.10 +/- 7.67%) were statistical ly significantly increased with cilazapril treatment without a signifi cant change in anaerobic threshold heart rate (123.3 +/- 20.4 beats/mi n vs 122.1 +/- 20.7 beats/min). Cilazapril treatment also decreased st atistically significantly the resting heart rate (91.4 +/- 20.1 beats/ min vs 85.3 +/- 17.6 beats/min) during follow-np. No patient decompens ated, and diuretic and digoxin doses were not changed during the study . No adverse effects of cilazapril were observed in any patient; howev er, the effect of cilazapril treatment-was not detected on echocardiog raphic variables. me conclude that the ACE inhibitor cilazapril may be useful in the treatment of patients with chronic congestive heart fai lure.