دورية أكاديمية
Angiotensin-converting enzyme inhibition as an adjunct to pulmonary rehabilitation in COPD
| العنوان: | Angiotensin-converting enzyme inhibition as an adjunct to pulmonary rehabilitation in COPD |
|---|---|
| المؤلفون: | Curtis, KJ, Meyrick, VM, Mehta, B, Haji, GS, Li, K, Montgomery, H, Man, WD-C, Polkey, MI, Hopkinson, NS |
| المساهمون: | Medical Research Council (MRC), National Institute for Health Research |
| المصدر: | 1357 ; 1349 |
| بيانات النشر: | American Thoracic Society |
| سنة النشر: | 2016 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Critical Care Medicine, Respiratory System, General & Internal Medicine, COPD, renin-angiotensin system, exercise, rehabilitation, SKELETAL-MUSCLE, QUADRICEPS STRENGTH, EXERCISE CAPACITY, GENE POLYMORPHISM, PHYSICAL FUNCTION, CAPTOPRIL, PERFORMANCE, TRIAL, MASS, renin–angiotensin system, Aged, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Combined Modality Therapy, Double-Blind Method, Enalapril, Exercise Tolerance, Female, Humans, Male, Pulmonary Disease |
| الوصف: | Rationale: Epidemiological studies in older individuals have found an association between use of ACE-inhibition (ACE-I) therapy and preserved locomotor muscle mass, strength and walking speed. ACE-I therapy might therefore have a role in the context of pulmonary rehabilitation. Objectives: We investigated the hypothesis that enalapril, an ACE-inhibitor, would augment the improvement in exercise capacity seen during pulmonary rehabilitation. Methods: We performed a double-blind, placebo-controlled, parallel-group randomised controlled trial. COPD patients, with at least moderate airflow obstruction and taking part in pulmonary rehabilitation, were randomised to either 10 weeks therapy with an ACE-inhibitor (10mg enalapril) or placebo. Measurements: The primary outcome measurement was the change in peak power (assessed using cycle ergometry) from baseline. Main Results: Eighty patients were enrolled, seventy-eight randomised (age 67±8years, FEV1 48±21% predicted), and sixty-five completed the trial (34 placebo, 31 ACE-inhibitor). The ACE-inhibitor treated group demonstrated a significant reduction in systolic blood pressure (Δ-16mmHg, 95% CI -22 to -11) and serum ACE activity (Δ-18IU/L, 95% CI -23 to -12) versus placebo (between group differences p<0.0001). Peak power increased significantly more in the placebo group (placebo Δ+9 Watts, 95% CI 5 to 13 vs. ACE-I Δ+1 Watt, 95% CI -2 to 4, between group difference 8 Watts, 95% CI 3 to 13, p=0.001). There was no significant between group difference in quadriceps strength or health-related quality of life. Conclusion: Use of the ACE-inhibitor enalapril alongside a programme of pulmonary rehabilitation, in patients without an established indication for ACE-inhibition, reduced the peak work rate response to exercise training in COPD patients. Clinical trial registration available at www.controlled-trials.com, ID ISRCTN79038750. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| تدمد: | 1535-4970 |
| العلاقة: | American Journal of Respiratory and Critical Care Medicine; http://hdl.handle.net/10044/1/33331Test; MR/J000620/1; CTF-01-12-04; G0701628 |
| DOI: | 10.1164/rccm.201601-0094OC |
| الإتاحة: | https://doi.org/10.1164/rccm.201601-0094OCTest http://hdl.handle.net/10044/1/33331Test |
| حقوق: | Copyright © 2016 by the American Thoracic Society |
| رقم الانضمام: | edsbas.12E94E44 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 15354970 |
|---|---|
| DOI: | 10.1164/rccm.201601-0094OC |