Key result
Captopril and enalapril increased cardiac output and decreased filling pressures in patients with congestive heart failure, with marked interindividual variations.
Why the study?
Does peroral administration of converting enzyme inhibitors (captopril or enalapril) improve acute hemodynamics in patients with congestive heart failure?
Observational (n=16)
Does peroral administration of converting enzyme inhibitors (captopril or enalapril) improve acute hemodynamics in patients with congestive heart failure?
Acute administration of ACE inhibitors in congestive heart failure improves hemodynamics on average but carries a risk of hypotension, particularly in patients with hypovolemia from excessive loop diuretic use.
Acute ACEI use may improve hemodynamics in HF on average; case reports leave open hypotension risk and patient selection for trials.
The acute hemodynamic response to captopril (8 patients) and enalapril (8 patients) was evaluated in congestive heart failure patients in NYHA functional class III. All patients had a history of congestive heart failure for more than six months. The results show marked interindividual variations but average values for cardiac output increase and decrease in filling pressures agree with findings in the literature. 6 patients in the captopril group and five in the enalapril group were started on maintenance therapy. One patient in the captopril group deteriorated and underwent a successful heart transplantation and one patient in the enalapril group returned with arrhytmias and hypertension (probably not drug-related) after 48 h of therapy. Our data indicate that activation of the renin-angiotensin system through excessive administration of loop-diuretics is associated with a risk of hypovolemia and thus drug-induced hypotension that deserves special attention when considering converting enzyme inhibitor therapy in congestive heart failure.
No takes yet. Share an insight, caveat, or question.
Lantz et al. (1984) conducted an observational in Congestive heart failure (n=16). Captopril and enalapril was evaluated on Acute hemodynamic response (cardiac output and filling pressures). Captopril and enalapril increased cardiac output and decreased filling pressures in patients with congestive heart failure, with marked interindividual variations.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: