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      Endogenous Prostaglandin E 2 Metabolite Levels, Renin-Angiotensin System and Catecholamines versus Acute Hemodynamic Response to Captopril in Chronic Congestive Heart Failure

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          Abstract

          Hemodynamic and hormonal responses to captopril were measured in 10 patients with severe chronic heart failure poorly controlled by digitalis and diuretics. After administration of a 25-mg dose, stroke volume (SV) increased from 53 ± 7 to 63 ± 9ml(p < 0.05), while pulmonary wedge pressure (PWP) decreased from 20 ± 2 to 14 ± 2 mm Hg (p < 0.01). The hemodynamic changes were associated with increases in plasma renin activity (PRA; p < 0.05) and in plasma levels of a novel bicyclo-prostaglandin E<sub>2</sub> metabolite (bicycle-PGE-m; p < 0.01), whereas norepinephrine (NE) showed a falling tendency. In general, basal hemodynamic and basal hormonal levels did not correlate. Captopril-induced changes in mean artery pressure (MAP) and mean pulmonary artery pressure (mPAP) were positively correlated to pre-captopril PRA (r = 0.74, p < 0.01; r = 0.64, p < 0.05) and to changes in PRA (r = 0.85, p < 0.01;r = 0.80, p < 0.01) with a similar trend for angiotensin II (All); decreases of systemic vascular resistance were more pronounced in patients with higher control NE levels (r = 0.62, p < 0.05), the reduction of NE levels being highest in patients with higher basal concentrations (p < 0.001); the captopril-induced decreases of mPAP and PWP were inversely related to basal bicyclo-PGE-m levels (r = 0.60, p < 0.05; r = 0.61, p < 0.05), and changes in mPAP were closely related to basal ratios of All/bicyclo-PGE-m (r = 0.67, p < 0.01). Thus, captopril exerts its acute beneficial hemodynamic effect by inhibiting the generation of All, associated with toning down of sympathetic stimulation and increased production of vasodilating prostaglandins, such as PGE<sub>2</sub>The relation between All and PGE<sub>2</sub> – counteracting substances – might determine the hemodynamic response to captopril in the patients.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1983
          1983
          07 November 2008
          : 70
          : 6
          : 297-307
          Affiliations
          2nd Department of Internal Medicine, University of Vienna, and Ludwig Boltzmann Institute for Clinical Endocrinology, Vienna, Austria
          Article
          173612 Cardiology 1983;70:297–307
          10.1159/000173612
          6370431
          © 1983 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 11
          Categories
          Original Paper

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