Munich Mild Heart failure Trial - MHFT


Captopril for clinical progression in mild heart failure.


Angiotensin converting enzyme inhibitors favorably influence the natural history of heart failure.

Study Design

Study Design:

Patients Screened: Not given
Patients Enrolled: 170
NYHA Class: I=(26%), II=(50%),III=(24%)
Mean Follow Up: 32 months (60 months)
Mean Patient Age: 62
Female: 25
Mean Ejection Fraction: 35%

Patient Populations:

NYHA class I-III heart failure


NYHA class IV congestive heart failure
Myocardial infarction within 3 weeks
Systolic BP < 95 mmHg
Uncontrolled hypertension
Valvular heart disease
Renal artery stenosis
Renal failure requiring dialysis
Other life-threatening diseases

Primary Endpoints:

Progression of congestive heart failure to NYHA class IV
Death due to progressive congestive heart failure
Sudden cardiac death

Secondary Endpoints:

Severity of dyspnea/fatigue
Number of hospitalizations
Change in ejection fraction
Drop out rate/adverse events

Drug/Procedures Used:

Captopril 25mg BID

Concomitant Medications:

Diuretics (79%)
Digitalis (59%)
Nitrates (59%)
Beta blockers (23%)
Antiarrhythmics (23%)
Calcium channel blockers (23%)

Principal Findings:

Congestive heart failure progressed to class IV in 10.8% treated with Captopril and 26.4% treated with placebo (p = 0.01).

Mean time to deterioration was longer in Captopril group.

Progression to NYHA class IV was a powerful predictor of death.

50% of deaths in placebo group due to progressive congestive heart failure but only 18% in Captopril group.


"Angiotensin converting enzyme inhibitors in conjunction with standard therapy early in the course of congestive heart failure slowed the progress of heart failure and thus favorably altered the natural history of the disease." (From Abstract)


1. Br Heart J 1992;67:289-96. Final results
2. Am J Cardiol 1993;71:1237-9. Long-term survival

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Heart Failure, Captopril, Disease Progression

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