What is the clinical evidence from this study?

Study design: Other. Population: Refractory heart failure (n=10). Intervention: Captopril. Primary outcome: Cardiac index (p=<0.001).

What question did this study set out to answer?

To evaluate the clinical efficacy, acute hemodynamic responses, and long-term tolerability of oral captopril in patients with refractory heart failure.

November 7, 2008Cardiology

Captopril in Refractory Heart Failure: Clinical and Hemodynamic Observations

Q: What are the key findings of this study?

Captopril treatment in refractory heart failure significantly increased cardiac index from 1.99 to 2.69 l/min/m (p<0.001) and decreased pulmonary capillary wedge pressure.

Q: What question did this study set out to answer?

To evaluate the clinical efficacy, acute hemodynamic responses, and long-term tolerability of oral captopril in patients with refractory heart failure.

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Key result

Captopril treatment in refractory heart failure significantly increased cardiac index from 1.99 to 2.69 l/min/m (p<0.001) and decreased pulmonary capillary wedge pressure.

Why the study?

Does oral captopril improve hemodynamics and clinical symptoms in patients with refractory heart failure?

Population

10 patients with refractory heart failure

Design

Case_series

Follow-up

6 months

Authors

EAEdward G. AbinaderBnai Zion Medical Center DSDawod SharifAdventHealth Kissimmee TRT. RosenfeldHaifa Medical Center

Discussion

Member takes

Implication

Supports hemodynamic effects of captopril in refractory HF; hypothesis-generating and requires randomized confirmation.

Key Points

To evaluate the clinical efficacy, acute hemodynamic responses, and long-term tolerability of oral captopril in patients with refractory heart failure.
Administered oral captopril (optimal dose 50 mg) to 10 patients with refractory heart failure secondary to ischemic heart disease (N=9) or valvular heart disease (N=1).
Monitored hemodynamic parameters from 0.5 to 6 hours post-dose and followed clinical outcomes over a 6-month period.
Cardiac index increased significantly from 1.99 ± 0.1 to 2.69 ± 0.15 l/min/m² (p < 0.001), while heart rate decreased from 83.4 ± 10.9 to 70.8 ± 10.14 bpm (p < 0.01).
Pulmonary capillary wedge pressure dropped from 25.3 ± 5.86 to 13.67 ± 4.14 mm Hg (p < 0.001), alongside substantial reductions in total peripheral and pulmonary resistance.
All patients achieved functional improvement to class II–IIB and resolution of pulmonary congestion, with clinical benefits maintained over 6 months without developing tolerance.

Structured PICO

Does oral captopril improve hemodynamics and clinical symptoms in patients with refractory heart failure?

Population

10 patients with refractory heart failure (9 ischemic, 1 valvular) treated with captopril and followed for 6 months.

Intervention

Oral captopril (optimal dose 50 mg)

Outcome

Hemodynamic parameters (cardiac index, pulmonary capillary wedge pressure, mean peripheral arterial blood pressure, total peripheral resistance, total pulmonary resistance, heart rate)surrogate

Main Result

Absolute Event Rate: 2.69% vs 1.99%

p-value: p=<0.001

Oral captopril provides significant and sustained hemodynamic and clinical improvement in patients with refractory heart failure without late vasodilator tolerance.

Cite This Study

Abinader et al. (2008) studied Refractory heart failure (n=10). Captopril was evaluated on Cardiac index (p=<0.001). Captopril treatment in refractory heart failure significantly increased cardiac index from 1.99 to 2.69 l/min/m (p<0.001) and decreased pulmonary capillary wedge pressure.

synapsesocial.com/papers/6a6f2efaf44fa9f079dc983e https://doi.org/10.1159/000173615

Topics

Heart failure HFrEF treatment Valvular heart disease Heart failure hospitalization

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Captopril in Refractory Heart Failure: Clinical and Hemodynamic Observations

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

Topics

Captopril in Refractory Heart Failure: Clinical and Hemodynamic Observations

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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