The effect of captopril on renal, coronary, and systemic hemodynamics in patients with severe congestive heart failure

American Heart Journal
E R PowersP J Cannon

Abstract

The effects of captopril (CPT), an oral angiotensin-converting enzyme (ACE) inhibitor, on systemic failure (CHF). In 15 patients, CPT decreased mean arterial pressure from 75 +/- 3 to 60 +/- 3 mm Hg associated with a 16% increase in cardiac output, a 24% reduction in systemic vascular resistance, and a 36% decrease in pulmonary capillary wedge pressure (all p less than 0.01). Despite the improved cardiac output, renal blood flow, creatinine clearance, and sodium excretion did not rise during the first 2 days of CPT therapy. In eight patients, coronary sinus blood flow diminished from 98 +/- 11 to 82 +/- 9 ml/min (p less than 0.01) following drug administration in association with a fall in arterial pressure and heart rate but no change in coronary sinus oxygen inhibitor failed to improve renal hemodynamics. In addition, initial CPT administration produced a decrease in coronary blood flow that was related to a decrease in myocardial oxygen requirements.

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Oct 1, 1992·Cardiovascular Drugs and Therapy·J P DegauteP Vandepapeliere
Dec 1, 1989·Cardiovascular Drugs and Therapy·J L RouleauJ de Champlain
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Jan 1, 1986·Acta Medica Scandinavica. Supplementum·K Swedberg

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