Author + information
- Received February 25, 1991
- Revision received June 3, 1991
- Accepted June 24, 1991
- Published online December 1, 1991.
- Richard F. Davies, MD, PhD, FACC∗,
- Donald S. Beanlands, MD, FACC,
- Claude Nadeau, MD,
- Denis Phaneuf, MD, FACC,
- Andrew Morris, MD, FACC,
- J.Malcolm Arnold, MD, FACC,
- John O. Parker, MD, FACC,
- Ronald Baigrie, MD, FACC,
- Paul Latour, MD,
- W.Peter Klinke, MD, FACC,
- Victoria Bernstein, MD, FACC,
- Marie-Helene Leblanc, MD,
- Henry Mizgala, MD, FACC,
- Andrew Stevens, PhD,
- Guy Boisvert,
- for the Canadian Enalapril Versus Digoxin Study Group
- ↵∗Address for reprints: Richard F. Davies, MD, University of Ottawa Heart Institute, Ottawa Civic Hospital, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada.
Patients with New York Heart Association functional class II or III heart failure stabilized on furosemide therapy were entered into a randomized controlled trial comparing enalapril (n = 72) and digoxin (n = 73). End points were clinical outcome, treadmill exercise capacity and echocardiographic left ventricular dimensions. Improvement in clinical outcome was defined as a reduction of at least one functional class, and deterioration as an increase of at least one functional class or withdrawal because of an adverse clinical event.
After 4 weeks, 13 patients receiving enalapril showed improvement, 55 had no change and 9 manifested deterioration compared with 7, 49 and 17, respectively, in the digoxin group (p < 0.01). After 14 weeks, 13 patients receiving enalapril showed improvement, 50 had no change and 9 manifested deterioration, compared with 14, 37 and 22, respectively, in the digoxin group (p < 0.025). More patients in the digoxin group were withdrawn because of an adverse clinical event (p < 0.05).
Exercise time and percent fractional shortening improved in both groups (p < 0.001 and <0.05, respectively), with no significant difference between groups (p >0.50). Both rate-pressure product and subjectively evaluated exertion during submaximal exercise were reduced only in the enalapril group. Although the majority of patients in both groups did well, those receiving enalapril experienced fewer adverse clinical events and had less fatigue during submaximal exercise.
☆ This study was supported by a grant from Merck Frosst Canada, Inc.
- Received February 25, 1991.
- Revision received June 3, 1991.
- Accepted June 24, 1991.