What does this research mean for the field?

Captopril administration in patients with severe acute and chronic heart failure produces sustained hemodynamic and clinical improvements, including increased cardiac output and reduced filling pressures, which correlate with pretreatment plasma renin levels. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the acute and long-term hemodynamic and neurohormonal effects of captopril in patients with acute and chronic severe heart failure.

January 1, 1983HeartOpen Access

Effects of captopril in acute and chronic heart failure. Correlations with plasma levels of noradrenaline, renin, and aldosterone.

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Why the study?

Does captopril improve haemodynamics and neurohormonal profiles in patients with severe acute and chronic heart failure?

Population

19 patients with severe heart failure and raised cardiac filling pressures.

Design

Case_series

Follow-up

3 months

Authors

GWG. J. WentingErasmus MC AVA. J. Man inʼt VeldRotterdam University of Applied Sciences AWA. J. J. WoittiezZiekenhuis Groep Twente

Discussion

Member takes

Implication

Supports ACE inhibitor evaluation in severe HF; hypothesis-generating from Level 5 case data.

Key Points

To evaluate the acute and long-term hemodynamic and neurohormonal effects of captopril in patients with acute and chronic severe heart failure.
Administered oral captopril (50 mg) to 19 patients with severe heart failure (7 with acute myocardial infarction, 12 with chronic myocardial damage; all baseline pulmonary capillary wedge pressure ≥17 mmHg).
Assessed correlations between pretreatment plasma renin and acute hemodynamic/hormonal responses, followed by a 3-month evaluation in 9 of the 14 patients offered long-term therapy.
Acute captopril administration increased stroke volume and cardiac output while decreasing heart rate, cardiac filling pressures, systemic arterial pressure, plasma aldosterone, and noradrenaline.
Reductions in cardiac filling pressures, systemic arterial pressure, and total peripheral resistance correlated positively with pretreatment plasma renin concentrations.
At 3 months, 9 patients showed sustained improvements in cardiac output and filling pressures, though 4 patients with severe coronary disease suffered sudden death following initial improvement.

Structured PICO

Does captopril improve haemodynamics and neurohormonal profiles in patients with severe acute and chronic heart failure?

Population

19 patients with severe heart failure (7 with acute myocardial infarction, remainder with chronic myocardial damage caused by ischaemia or valvular disease) and raised cardiac filling pressures (pulmonary capillary wedge pressure ≥17 mmHg).

Intervention

Captopril 50 mg orally acutely, followed by long-term treatment in 14 patients.

Outcome

Changes in haemodynamics (stroke volume, cardiac output, heart rate, cardiac filling pressures, systemic arterial pressure) and plasma concentrations of aldosterone and noradrenaline.surrogate

Captopril provides acute and sustained haemodynamic improvements in severe heart failure, accompanied by favorable neurohormonal changes.

Limitations

Lack of information about its effect on coronary blood flow

Cite This Study

Wenting et al. (1983) studied this question.

synapsesocial.com/papers/6a1be904ea84844e355f2aa0 https://doi.org/10.1136/hrt.49.1.65

Topics

Heart failure HFrEF treatment

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Effects of captopril in acute and chronic heart failure. Correlations with plasma levels of noradrenaline, renin, and aldosterone.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Effects of captopril in acute and chronic heart failure. Correlations with plasma levels of noradrenaline, renin, and aldosterone.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider