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      Captopril in Refractory Heart Failure: Clinical and Hemodynamic Observations

      , , ,

      Cardiology

      S. Karger AG

      Captopril, Heart failure, Hemodynamic effects

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          Abstract

          10 patients suffering from refractory heart failure were treated with an oral angiotensin converting enzyme inhibitor captopril. The etiology of heart failure in 9 patients was related to ischemic heart disease, and to valvular heart disease in 1 patient. All patients experienced subjective improvement and feeling of well-being. The functional capacity improved to class II-IIB. Serial chest X-ray films showed improvement in pulmonary congestion. The time course of the hemodynamic effect appeared to 0.5–1.5 h after intake, and tended to disappear about 6 h later. The optimal dose of the drug achieving maximal hemodynamic benefit without excessive hypotension was 50 mg. Some of the patients exhibited a triphasic response. The cardiac index increased from 1.99 ± 0.1 to 2.69 ± 0.151/min/m (p < 0.001), while pulmonary capillary wedge pressure decreased from 25.3 ± 5.86 to 13.67 ± 4.14 mm Hg (p < 0.001). Mean peripheral arterial blood pressure decreased from 90.06 ± 3.7 to 71.4 ± 2.7 mm Hg. The total peripheral resistance decreased from 1,942 ± 169 to 1,170 ± 109 dyn × s × cm<sup>-5</sup>. The total pulmonary resistance decreased from 272.6 ± 42.9 to 142.34 ± 13.76 dyn × s × cm<sup>-5</sup>. Heart rate decreased from 83.4 ± 10.9 to 70.8 ± 10.14 bpm (p < 0.01). During a 6-month follow-up period the beneficial clinical effects of captopril were sustained, without late vasodilator tolerance. 1 death, unrelated to captopril, occurred. 2 patients developed transient rash, and 1 experienced transient dysgeusia.

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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
          : 326-332
          Affiliations
          Heart Institute and Intensive Coronary Care Unit, Haifa City Medical Center (Rothschild), and Faculty of Medicine, Technion Haifa, Israel
          Article
          173615 Cardiology 1983;70:326–332
          10.1159/000173615
          6370433
          © 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: 7
          Categories
          Original Paper

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