QUALITY-OF-LIFE WITH ACE-INHIBITORS IN CHRONIC HEART-FAILURE

The randomized trials assessing the effect of angiotensin-converting e nzyme (ACE) inhibitors in chronic heart failure (CHF) are reviewed. Th e Minnesota Living with Heart Failure Questionnaire has demonstrated t he benefits of enalapril in some but not all circumstances and the Yal e Dyspnea-Fatigue Index improves with lisinopril. A recent trial of bo th cilazapril and captopril vs. placebo employed the Sickness Impact P rofile and supports the concept that ACE inhibitors have a small (and in this trial nonsignificant) beneficial effect on mobility. Other vas odilators and inotropes may also have small benefits on quality of lif e, such that comparisons of an ACE inhibitor with vasodilators, as was done in the V-HeFT II trial, fail to reveal any different effects on quality of life.