EXERCISE CAPACITY IN PATIENTS WITH LEFT-VENTRICULAR DYSFUNCTION FOLLOWING ACUTE MYOCARDIAL-INFARCTION - RELATION TO SYSTOLIC AND DIASTOLIC FUNCTION AND INTERVENTION WITH CAPTOPRIL

Patients with acute or chronic heart disease may have limited exercise capacity if they have reduced left ventricular function. Indexes of r educed left ventriuclar function during exercise are a predictor of su bsequent survival although left ventricular ejection fraction is a poo r predictor of physical endurance. We evaluated the effect of captopri l on physical endurance in 48 males with left ventricular dysfunction following myocardial infarction. On the 7th day following myocardial i nfarction patients were randomized to either captopril 50 mg daily or corresponding placebo. Patients were followed up by means of serial ec hocardiography and exercise stress testing for a period of 180 days. E xercise capacity was significantly improved in the captopril group. Ch anges in exercise capacity were significantly correlated to changes in left ventricular (LV) volumes and compliance. The beneficial effect o f captopril on exercise capacity was probably mediated via improvement in LV performance and compliance.