Archives of the Turkish Society of Cardiology
Effects of Sublingual Administration of Captopril on Parameters of Exercise Test and Neurohormonal Activation in Patient with Stable Angina Pectoris [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1996; 24(7): 425-432

Effects of Sublingual Administration of Captopril on Parameters of Exercise Test and Neurohormonal Activation in Patient with Stable Angina Pectoris

Kani GEMİCİ1, Ali Rıza KAZAZOĞLU1, Dilek YEŞİLBURSA1, Akın SERDAR1, Serdar ENER2, Ali AYDINLAR1, Levent BÜYÜKUYSAL3, Nedim ÇOBANOĞLU1
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A prospective study was designed to investigate the effects of sublingual captopril (C) on parameters of exercise test and neurohormonal activation in patients with stable angina pectoris. The study was performed as randomized, double-blind and placebo controlled in 31 patients (28 male, 3 female; mean age 55.4±9.4 years) with stable angina pectoris. Coronary angiography and ventriculography were performed in all cases and the patients were classified according to the left ventricular ejection fraction (EF) (EF >56 %, Group A; EF=50-55 %, Group B; EF=40-49%, Group C; EF<40%, Group D). Following sublingual placebo, basal plasma renin, angiotensin II, norepinephrine (NE) and serum aldosterone levels were measured and a maximal exercise test was performed by modified Bruce protocol. Hormone levels were remeasured immediately after exercise. The same procedure was completely repeated using either placebo or C the next day. Sublingual C administration increased the time to angina (p<0.001), the time to 1 mm ST depression (p<0.01), maximal exercise capacity (p<0.001) and maximal exercise duration (p<0.001); decreased maximal ST depression (p<0.001), maximal systolic blood pressure (p<0.001), and maximal double product (p<0.01). Maximal heart rate was not significantly different. After the maximal exercise test following C administration, the increments of angiotensin II, aldosterone and norepinephrine levels were found to be significantly lower and the increment of the renin level was found to be significantly higher than those of placebo (p<0.001). The effects of sublingual C use on exercise parameters were assessed in different left ventriculr systolic function subgroups additinally. Delay in the time to angina was found statistically significant in group A. A favorable effect on about all parameters including maximal effort time were observed in groups B, C and D. An increasing favorable effect on maximal effort time and capacity was recognized from group A to group D. There were no adverse reactions related to sublingual C use. As a result, sublingual administration of C improved the parameters of maximal exercise test and supressed the neurohormonal activation during exercise. The favorable effects were more prominent in cases with left ventricular systolic dysfunction. We suggest that sublingual C can be used effectively before planned daily activities in patients with stable angina pectoris.


How to cite this article
Kani GEMİCİ, Ali Rıza KAZAZOĞLU, Dilek YEŞİLBURSA, Akın SERDAR, Serdar ENER, Ali AYDINLAR, Levent BÜYÜKUYSAL, Nedim ÇOBANOĞLU. Effects of Sublingual Administration of Captopril on Parameters of Exercise Test and Neurohormonal Activation in Patient with Stable Angina Pectoris. Turk Kardiyol Dern Ars. 1996; 24(7): 425-432
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