Canesin M F, Barretto A C, Oliveira Júnior M T, Bodanese L C, Marafon P, Arsencio S R
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo, Hospital São Lucas-PUC, Porto Alegre.
Arq Bras Cardiol. 1996 Aug;67(2):77-80.
Considering that heart failure reduces exercise capacity and that converting enzyme inhibitor increases this capacity, using the 6 min walk test we try to demonstrate when the treatment with captopril shows a better improvement in exercise capacity in patients with heart failure.
Twenty one patients with functional class II or III heart failure (NYHA), left ventricular diastolic diameter greater than 55 mm and with ejection fraction less than 45% were studied. Twelve were male, and the patients mean age was 48 years. The patients were first treated with digital and diuretics and after stabilized they received captopril 25 mg three times a day and underwent the 6 min walk test before the treatment and after four and 16 weeks.
The use of captopril showed important improvement in exercise capacity in patients with heart failure. The mean walking distance on the 6 min test was 451 m at the beginning, 476 m in four weeks and 504 in 16 weeks of treatment (p < 0.0001).
Our data show important improvement in exercise capacity with 16 weeks of treatment and that 50% of this improvement occurred after four weeks of treatment. We concluded that the results are already observed within four weeks of treatment and continues to improve during at least four months of treatment.
鉴于心力衰竭会降低运动能力，而转换酶抑制剂可提高这种能力，我们试图通过6分钟步行试验来证明卡托普利治疗何时能使心力衰竭患者的运动能力得到更好改善。
对21例功能分级为II或III级心力衰竭（纽约心脏协会分级）、左心室舒张直径大于55mm且射血分数小于45%的患者进行研究。其中12例为男性，患者平均年龄为48岁。患者首先接受洋地黄和利尿剂治疗，病情稳定后，每天三次服用25mg卡托普利，并在治疗前、治疗4周和16周后进行6分钟步行试验。
使用卡托普利使心力衰竭患者的运动能力有显著改善。6分钟试验的平均步行距离在开始时为451m，治疗4周时为476m，治疗16周时为504m（p<0.0001）。
我们的数据显示，治疗16周后运动能力有显著改善，且这种改善的50%发生在治疗4周后。我们得出结论，治疗4周内即可观察到结果，且在至少4个月的治疗期间持续改善。
