What question did this study set out to answer?

To assess the systemic, pulmonary, and regional hemodynamic effects, as well as neurohormonal responses, of a single oral dose of spirapril in severe congestive heart failure.

March 4, 1996Fundamental and Clinical Pharmacology

Systemic, pulmonary, brachial, renal and hepato‐splanchnic hemodynamic effects of spirapril in severe congestive heart failure

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Why the study?

Does a single oral dose of spirapril improve hemodynamics in patients with severe congestive heart failure?

Population

8 patients with severe congestive heart failure (CHF)

Design

Cohort

Follow-up

24 hours

Authors

ÉBÉric BellissantInserm DAD AnnaneInserm EPEric PussardUniversité Paris-Saclay

Discussion

Member takes

Implication

Supports acute hemodynamic benefit in severe HF; hypothesis-generating and requires RCTs before practice change.

Key Points

To assess the systemic, pulmonary, and regional hemodynamic effects, as well as neurohormonal responses, of a single oral dose of spirapril in severe congestive heart failure.
Administered a single 6 mg oral dose of the angiotensin-converting enzyme inhibitor spirapril to eight patients with severe congestive heart failure (N=8).
Monitored systemic, pulmonary, brachial, renal, and hepato-splanchnic hemodynamics alongside renin-angiotensin-aldosterone and sympathetic markers over 24 hours.
Reduced mean arterial pressure by 19%, right atrial pressure by 42%, mean pulmonary arterial pressure by 38%, and pulmonary capillary wedge pressure by 46%, with peak effects occurring between 2.5 and 4 hours.
Increased stroke volume index by 43%, brachial blood flow by 41%, and renal blood flow by 36%, accompanied by reductions in brachial (-41%) and renal (-36%) vascular resistances, while hepato-splanchnic hemodynamics remained unchanged.
Inhibited plasma converting enzyme activity by 96% and increased plasma renin activity by 505% at 4 hours, while decreasing aldosterone by 46% and norepinephrine by 31% at 24 hours.

Structured PICO

Does a single oral dose of spirapril improve hemodynamics in patients with severe congestive heart failure?

Population

8 patients with severe congestive heart failure (CHF)

Intervention

Spirapril 6 mg single oral dose

Outcome

Systemic, pulmonary and regional (brachial, renal, hepato-splanchnic) hemodynamics and biological parameters over a 24-hour periodsurrogate

A single 6 mg oral dose of spirapril exerts arterial and venous vasodilating properties, improving systemic and regional hemodynamics in severe congestive heart failure.

Cite This Study

Bellissant et al. (1996) studied this question.

synapsesocial.com/papers/6a90646ca9a6d70ff18a4fe3 https://doi.org/10.1111/j.1472-8206.1996.tb00155.x

Topics

Heart failure HFrEF treatment

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Systemic, pulmonary, brachial, renal and hepato‐splanchnic hemodynamic effects of spirapril in severe congestive heart failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Systemic, pulmonary, brachial, renal and hepato‐splanchnic hemodynamic effects of spirapril in severe congestive heart failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider