Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1994 Jan;70(1):35–39. doi: 10.1136/adc.70.1.35

Efficacy and dosage of enalapril in congenital and acquired heart disease.

A M Leversha 1, N J Wilson 1, P M Clarkson 1, A L Calder 1, M C Ramage 1, J M Neutze 1
PMCID: PMC1029679  PMID: 8110005

Abstract

In a tertiary referral centre 63 patients underwent 67 treatment periods with enalapril. The median age was 5.4 months. All children had signs of heart failure: congestive cardiac failure with breathlessness at rest was present in 88%. Haemodynamic groups were left-to-right shunt (n = 15), impaired ventricular function (n = 14), after cardiac surgery (n = 23), valvar regurgitation (n = 12), and hypertension (n = 3). Serial clinical, radiological, and laboratory data were used to judge outcome. The mean (SD) maximal dose was 0.30 (0.21) mg/kg/day. Thirty nine (58%) patients improved, 20 (30%) showed no improvement, and eight (12%) had side effects requiring discontinuation of enalapril. Renal failure in eight patients was related to young age, low weight, and left-to-right shunt group. Three patients died in congestive heart failure with renal failure. Enalapril was clinically safe and effective for children with cardiac failure secondary to ventricular impairment, valvar regurgitation, or after cardiac surgery. Renal failure was a problem in young infants with left-to-right shunts.

Full text

PDF
36

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bianchetti M. G., Caflisch M., Oetliker O. H. Cough and converting enzyme inhibitors. Eur J Pediatr. 1992 Mar;151(3):225–226. doi: 10.1007/BF01954391. [DOI] [PubMed] [Google Scholar]
  2. Boucek M. M., Chang R. L. Effects of captopril on the distribution of left ventricular output with ventricular septal defect. Pediatr Res. 1988 Oct;24(4):499–503. doi: 10.1203/00006450-198810000-00017. [DOI] [PubMed] [Google Scholar]
  3. Cleland J. G., Dargie H. J., Ball S. G., Gillen G., Hodsman G. P., Morton J. J., East B. W., Robertson I., Ford I., Robertson J. I. Effects of enalapril in heart failure: a double blind study of effects on exercise performance, renal function, hormones, and metabolic state. Br Heart J. 1985 Sep;54(3):305–312. doi: 10.1136/hrt.54.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cohn J. N., Johnson G., Ziesche S., Cobb F., Francis G., Tristani F., Smith R., Dunkman W. B., Loeb H., Wong M. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med. 1991 Aug 1;325(5):303–310. doi: 10.1056/NEJM199108013250502. [DOI] [PubMed] [Google Scholar]
  5. Coulter D. M., Edwards I. R. Cough associated with captopril and enalapril. Br Med J (Clin Res Ed) 1987 Jun 13;294(6586):1521–1523. doi: 10.1136/bmj.294.6586.1521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Davies R. O., Irvin J. D., Kramsch D. K., Walker J. F., Moncloa F. Enalapril worldwide experience. Am J Med. 1984 Aug 20;77(2A):23–35. doi: 10.1016/s0002-9343(84)80055-8. [DOI] [PubMed] [Google Scholar]
  7. Eronen M., Pesonen E., Wallgren E. I., Tikkanen I., Fyhrquist F., Andersson S. Enalapril in children with congestive heart failure. Acta Paediatr Scand. 1991 May;80(5):555–558. doi: 10.1111/j.1651-2227.1991.tb11905.x. [DOI] [PubMed] [Google Scholar]
  8. Frenneaux M., Stewart R. A., Newman C. M., Hallidie-Smith K. A. Enalapril for severe heart failure in infancy. Arch Dis Child. 1989 Feb;64(2):219–223. doi: 10.1136/adc.64.2.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Frohlich E. D., Cooper R. A., Lewis E. J. Review of the overall experience of captopril in hypertension. Arch Intern Med. 1984 Jul;144(7):1441–1444. [PubMed] [Google Scholar]
  10. Kjekshus J., Swedberg K. Tolerability of enalapril in congestive heart failure. Am J Cardiol. 1988 Jul 11;62(2):67A–72A. doi: 10.1016/s0002-9149(88)80088-2. [DOI] [PubMed] [Google Scholar]
  11. Lewis A. B., Chabot M. The effect of treatment with angiotensin-converting enzyme inhibitors on survival of pediatric patients with dilated cardiomyopathy. Pediatr Cardiol. 1993 Jan;14(1):9–12. doi: 10.1007/BF00794837. [DOI] [PubMed] [Google Scholar]
  12. Lloyd T. R., Mahoney L. T., Knoedel D., Marvin W. J., Jr, Robillard J. E., Lauer R. M. Orally administered enalapril for infants with congestive heart failure: a dose-finding study. J Pediatr. 1989 Apr;114(4 Pt 1):650–654. doi: 10.1016/s0022-3476(89)80715-2. [DOI] [PubMed] [Google Scholar]
  13. Moncloa F., Sromovsky J. A., Walker J. F., Davies R. O. Enalapril in hypertension and congestive heart failure. Overall review of efficacy and safety. Drugs. 1985;30 (Suppl 1):82–89. doi: 10.2165/00003495-198500301-00012. [DOI] [PubMed] [Google Scholar]
  14. Montigny M., Davignon A., Fouron J. C., Biron P., Fournier A., Elie R. Captopril in infants for congestive heart failure secondary to a large ventricular left-to-right shunt. Am J Cardiol. 1989 Mar 1;63(9):631–633. doi: 10.1016/0002-9149(89)90915-6. [DOI] [PubMed] [Google Scholar]
  15. Rheuban K. S., Carpenter M. A., Ayers C. A., Gutgesell H. P. Acute hemodynamic effects of converting enzyme inhibition in infants with congestive heart failure. J Pediatr. 1990 Oct;117(4):668–670. doi: 10.1016/s0022-3476(05)80712-7. [DOI] [PubMed] [Google Scholar]
  16. Rucinska E. J., Small R., Irvin J. High-risk patients treated with enalapril maleate: safety considerations. Int J Cardiol. 1989 Feb;22(2):249–259. doi: 10.1016/0167-5273(89)90075-2. [DOI] [PubMed] [Google Scholar]
  17. Scammell A. M., Arnold R., Wilkinson J. L. Captopril in treatment of infant heart failure: a preliminary report. Int J Cardiol. 1987 Sep;16(3):295–301. doi: 10.1016/0167-5273(87)90153-7. [DOI] [PubMed] [Google Scholar]
  18. Sharpe D. N., Murphy J., Coxon R., Hannan S. F. Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study. Circulation. 1984 Aug;70(2):271–278. doi: 10.1161/01.cir.70.2.271. [DOI] [PubMed] [Google Scholar]
  19. Shaw N. J., Wilson N., Dickinson D. F. Captopril in heart failure secondary to a left to right shunt. Arch Dis Child. 1988 Apr;63(4):360–363. doi: 10.1136/adc.63.4.360. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Sluysmans T., Styns-Cailteux M., Tremouroux-Wattiez M., de Lame P. A., Lintermans J., Rubay J., Vliers A. Intravenous enalaprilat and oral enalapril in congestive heart failure secondary to ventricular septal defect in infancy. Am J Cardiol. 1992 Oct 1;70(9):959–962. doi: 10.1016/0002-9149(92)90749-o. [DOI] [PubMed] [Google Scholar]
  21. Speirs C. J., Dollery C. T., Inman W. H., Rawson N. S., Wilton L. V. Postmarketing surveillance of enalapril. II: Investigation of the potential role of enalapril in deaths with renal failure. BMJ. 1988 Oct 1;297(6652):830–832. doi: 10.1136/bmj.297.6652.830. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Stern H., Weil J., Genz T., Vogt W., Bühlmeyer K. Captopril in children with dilated cardiomyopathy: acute and long-term effects in a prospective study of hemodynamic and hormonal effects. Pediatr Cardiol. 1990 Jan;11(1):22–28. doi: 10.1007/BF02239543. [DOI] [PubMed] [Google Scholar]
  23. Webster M. W., Neutze J. M., Calder A. L. Acute hemodynamic effects of converting enzyme inhibition in children with intracardiac shunts. Pediatr Cardiol. 1992 Jul;13(3):129–135. doi: 10.1007/BF00793943. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES