Steffensen R, Grande P, Madsen J K, Rasmussen S, Haunsø S
Department of Medicine B, Rigshospitalet, University of Copenhagen, Denmark.
Cardiology. 1995;86(6):445-50. doi: 10.1159/000176921.
A double-blind, placebo-controlled, crossover study was carried out to evaluate the short-term effects of captopril on exercise tolerance in 18 normotensive patients with chronic stable angina pectoris and normal left ventricular function. Captopril 25 mg (or placebo) was given twice, i.e. in the evening (10 p.m.) and the following morning (8 a.m.), prior to a maximal symptom-limited bicycle exercise test (11 a.m.). Captopril reduced the systolic and diastolic blood pressures at rest (p < 0.01) without causing any reflex tachycardia. The time to onset of S-T depression was prolonged (p < 0.05), and the maximal S-T depression was reduced (p < 0.02). No differences were found between captopril and placebo in total exercise duration or time to onset of angina. The effects of captopril on exercise-induced ischemia were demonstrated most clearly in patients who responded with a greater than 10 mm Hg fall in the resting systolic blood pressure. In conclusion, this study suggests that captopril has anti-ischemic properties, which may be of importance in the treatment of patients with chronic stable angina and normal left ventricular function. These beneficial effects probably relate to a reduction in afterload and myocardial wall stress and therefore a reduction in myocardial oxygen demand.
开展了一项双盲、安慰剂对照、交叉研究，以评估卡托普利对18例血压正常、患有慢性稳定型心绞痛且左心室功能正常的患者运动耐量的短期影响。在最大症状限制的自行车运动试验（上午11点）前，于晚上10点和次日上午8点两次给予卡托普利25毫克（或安慰剂）。卡托普利降低了静息时的收缩压和舒张压（p<0.01），且未引起任何反射性心动过速。ST段压低开始的时间延长（p<0.05），最大ST段压低程度降低（p<0.02）。卡托普利与安慰剂在总运动持续时间或心绞痛发作时间方面未发现差异。卡托普利对运动诱发缺血的作用在静息收缩压下降超过10毫米汞柱的患者中表现得最为明显。总之，本研究提示卡托普利具有抗缺血特性，这在慢性稳定型心绞痛且左心室功能正常的患者治疗中可能具有重要意义。这些有益作用可能与后负荷和心肌壁应力降低有关，从而心肌需氧量减少。
