PMID- 9853181
OWN - NLM
STAT- MEDLINE
DCOM- 19990303
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 21
IP  - 12
DP  - 1998 Dec
TI  - The effects of an angiotensin-converting inhibitor (enalapril) on patients with 
      mild cardiac failure--evaluating cardiac function based on the relationship 
      between daily walking pace and heart rate.
PG  - 893-8
AB  - BACKGROUND: Heart failure has been evaluated by several methods, the New York 
      Heart Association (NYHA) classification of heart failure based on symptoms being 
      used most frequently. However, the degree of heart failure assessed by these 
      criteria does not always correlate with cardiac function in daily life. 
      HYPOTHESIS: The aim of the study was to evaluate cardiac function based on the 
      walking pace/heart rate (HR) relationship to assess the effects of enalapril, an 
      angiotensin-converting enzyme inhibitor, in patients with mild to moderate 
      cardiac function. METHODS: To evaluate cardiac function objectively, we developed 
      a method using a pedometer to count the steps walked while simultaneously 
      recording HR using a Holter electrocardiograph (ECG). Step-count walk rate (WR) 
      was recorded on the magnetic tape of the Holter apparatus, and both HR and 
      walking pace were calculated automatically by the Holter ECG analysis system. 
      Data were determined every hour, and mean pace and HR were plotted along the x 
      and y axes, respectively. The slope of HR x WR was calculated using the least 
      squares method. The slope and the total number of steps were regarded as 
      indicators of cardiac function and quality of life, respectively. We analyzed 36 
      subjects, consisting of 8 normal volunteers, 8 patients in New York Heart 
      Association (NYHA) class I. 11 in class II, and 9 in class III chronic mild heart 
      failure, during maximal exercise work load by bicycle ergometer; furthermore, 
      fractional shortening of the left ventricle on echocardiogram was determined in 
      14 patients with chronic mild heart failure and was compared with the slope of HR 
      x WR. Enalapril was administered at a daily dose of 2.5-10 mg for 1-24 months 
      (mean 6 months) in 60 patients to evaluate the effects of this drug on these 
      parameters. RESULTS: There was a significant inverse relationship between maximal 
      work load and the HR x WR slope, and also between the fractional shortening and 
      the slope, suggesting that the slope may reflect the severity of cardiac 
      dysfunction. Furthermore, the slope decreased significantly from 1.8 +/- 1.26 
      before enalapril to 1.0 +/- 0.94 (mean +/- standard deviation) after drug 
      administration, while the total number of steps increased significantly from 4842 
      +/- 3581 to 7804 +/- 4793. CONCLUSION: The slope of the graph relating step count 
      and HR proved to be a good, objective indicator of cardiac function, and 
      enalapril therapy improved this parameter.
FAU - Inooka, E
AU  - Inooka E
AD  - Ohizumi Memorial Hospital, Miyagi Prefecture, Japan.
FAU - Umeda, S
AU  - Umeda S
FAU - Kutsuwa, Y
AU  - Kutsuwa Y
FAU - Takahashi, T
AU  - Takahashi T
FAU - Sagawa, K
AU  - Sagawa K
FAU - Takahashi, T
AU  - Takahashi T
FAU - Inooka, H
AU  - Inooka H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 69PN84IO1A (Enalapril)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Atrial Natriuretic Factor/blood
MH  - Child
MH  - Electrocardiography, Ambulatory
MH  - Enalapril/*therapeutic use
MH  - Exercise Test/methods
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - *Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - *Walking/physiology
PMC - PMC6656159
EDAT- 1998/12/16 00:00
MHDA- 1998/12/16 00:01
PMCR- 2009/02/03
CRDT- 1998/12/16 00:00
PHST- 1998/12/16 00:00 [pubmed]
PHST- 1998/12/16 00:01 [medline]
PHST- 1998/12/16 00:00 [entrez]
PHST- 2009/02/03 00:00 [pmc-release]
AID - CLC4960211207 [pii]
AID - 10.1002/clc.4960211207 [doi]
PST - ppublish
SO  - Clin Cardiol. 1998 Dec;21(12):893-8. doi: 10.1002/clc.4960211207.