Enalapril Does Not Enhance Exercise Capacity in Patients After Fontan Procedure

摘要: Background Angiotensin-converting enzyme inhibitors improve exercise capacity in adults with congestive heart failure by decreasing systemic vascular resistance and improving ventricular diastolic function. Patients who have undergone the Fontan procedure decreased cardiac output, increased resistance, abnormal function, compared normal people. Methods Results To test hypothesis that afterload reduction therapy alters hemodynamic variables augments patients after a procedure, we results of graded maximal effort from 18 subjects (14.5±6.2 years age, 4 to 19 procedure) randomized, double-blind, placebo-controlled crossover trial using enalapril (0.2 0.3 mg · kg−1 d−1, maximum 15 mg). Each treatment was administered for 10 weeks. Diastolic filling patterns at rest were assessed Doppler determination atrioventricular valve flow velocity conclusion each therapy. No difference detected resting rate, blood pressure, or index. also similar. Exercise duration not different (6.4±2.6 [enalapril] versus 6.7±2.6 minutes [placebo]). The mean percent increase index slightly but significantly weeks (102±34% 125±34% [placebo]; P <.02). At exercise, (3.5±0.9 3.8±0.9 L min−1 m2 [placebo]), oxygen consumption (18.3±9 20.5±7 mL minute ventilation (57.5±17 55.4±19 L/min total work (247±181 261±197 W [placebo]) different. Conclusions We conclude administration does alter index, procedure.