Study objectives: Respiratory muscle strength has been
shown to be reduced in patients with chronic heart failure. The
purpose of this prospective study was to determine whether long-term
therapy with the angiotensin-converting enzyme (ACE) inhibitor
perindopril improves respiratory muscle strength in patients with
chronic heart failure.
Patients and methods: Eighteen
patients with stable chronic heart failure were administered
perindopril, 4 mg/d, in addition to their standard therapy for a period
of 6 months. Fourteen patients completed the study. Maximum inspiratory
pressure (Pimax) and maximum expiratory pressure
(Pemax) expressed in percentage of predicted values, left
ventricular ejection fraction (LVEF) determined by means of
two-dimensional echocardiography, and pulmonary volumes were obtained
before and after therapy.
Measurements and results: As
compared to baseline, there was a significant increase in both
Pimax and Pemax after therapy (57 ± 27%
predicted vs 78 ± 36% predicted and 62 ± 20% predicted vs
73 ± 15% predicted, respectively; each p < 0.05). LVEF increased
(34 ± 5% vs 41 ± 10%; p < 0.05); functional class improved
by ≥ 1 New York Heart Association (NYHA) class in five patients.
There were no changes in pulmonary volumes. No correlation was found
between changes in Pimax and Pemax and changes
in either LVEF or NYHA functional class.
In patients with chronic heart failure, long-term therapy with the ACE
inhibitor perindopril improved respiratory muscle strength, as
indicated by significant increases in Pimax and