Hasija P K, Karloopia S D, Shahi B N, Chauhan S S
Base hospital, Delhi Cantt-10.
J Assoc Physicians India. 1998 Feb;46(2):189-93.
Ventricular arrhythmias are considered to be related to left ventricular (LV) dysfunction. ACE inhibitors though improve LV function their beneficial role on exercise-induced ventricular arrhythmias is not established. To study the effects of ACE inhibitors on exercise capacity vis-a-vis their role on exercise-induced ventricular arrhythmias, 25 patients of congestive heart failure (CHF) of various etiologies in NYHA Class II and III were subjected to a prospective randomised controlled trial. The control group comprising of 12 patients received conventional treatment (digitalis and diuretics) and the test group was given enalapril/captopril in addition as tolerated. They were followed up for 3 months. Exercise testing on treadmill and monitoring of clinical and biochemical parameters were done at the beginning and end of study in all cases. Ventricular arrhythmias observed during exercise and post-exercise for 10 minutes was analysed using Lown's grading for frequency and severity of ventricular arrhythmia. The mean exercise duration showed significant improvement on ACE inhibitor as compared to the control group (p < 0.05) however there was no significant change in the grades of arrhythmia. Serum electrolytes and other bio-chemical parameter were within normal range. It is concluded that effect of ACE inhibitor on improving functional capacity in CHF is independent of it's any effect on exercise-induced ventricular arrhythmias.
室性心律失常被认为与左心室（LV）功能障碍有关。尽管血管紧张素转换酶（ACE）抑制剂可改善左心室功能，但它们对运动诱发的室性心律失常的有益作用尚未得到证实。为了研究ACE抑制剂对运动能力的影响及其对运动诱发的室性心律失常的作用，对25例纽约心脏协会（NYHA）心功能II级和III级、病因各异的充血性心力衰竭（CHF）患者进行了一项前瞻性随机对照试验。对照组由12例患者组成，接受常规治疗（洋地黄和利尿剂），试验组在耐受的情况下加用依那普利/卡托普利。对他们进行了3个月的随访。所有患者在研究开始和结束时均进行了跑步机运动试验，并监测了临床和生化参数。使用洛恩（Lown）分级法分析运动期间及运动后10分钟观察到的室性心律失常的频率和严重程度。与对照组相比，ACE抑制剂治疗组的平均运动持续时间有显著改善（p < 0.05），但心律失常的分级没有显著变化。血清电解质和其他生化参数均在正常范围内。得出的结论是，ACE抑制剂改善CHF患者功能能力的作用与其对运动诱发的室性心律失常的任何作用无关。
