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. 1982 Mar;47(3):233–238. doi: 10.1136/hrt.47.3.233

Haemodynamic and myocardial metabolic effects of captopril in chronic heart failure.

K Chatterjee, J L Rouleau, W W Parmley
PMCID: PMC481127  PMID: 7037025

Abstract

In 15 patients with chronic left ventricular failure caused by ischaemic heart disease, cardiac output and right heart pressures were measured before and after the oral angiotensin-converting enzyme inhibitor, captopril, which was administered in increasing doses. In 12 of 15 patients, coronary blood flow, and in 11 patients myocardial oxygen extraction and consumption and lactate extraction were also determined before and after captopril therapy. Cardiac index and stroke volume index increased by an average of 25% and 27%, respectively. Pulmonary capillary wedge pressure also decreased in all patients (average 27%), suggesting improved left ventricular function. The rate-pressure product, coronary blood flow, and myocardial oxygen consumption decreased significantly; in one of 11 patients there was myocardial lactate production, despite decreased myocardial oxygen demand and consumption. These findings suggest that in patients with chronic heart failure, improved left ventricular function with captopril is generally associated with decreased metabolic cost and that deterioration of metabolic function occurs infrequently.

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Selected References

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

  1. Ader R., Chatterjee K., Ports T., Brundage B., Hiramatsu B., Parmley W. Immediate and sustained hemodynamic and clinical improvement in chronic heart failure by an oral angiotensin-converting enzyme inhibitor. Circulation. 1980 May;61(5):931–937. doi: 10.1161/01.cir.61.5.931. [DOI] [PubMed] [Google Scholar]
  2. Awan N. A., Evenson M. K., Needham K. E., Win A., Mason D. T. Efficacy of oral angiotensin-converting enzyme inhibition with captopril therapy in severe chronic normotensive congestive heart failure. Am Heart J. 1981 Jan;101(1):22–31. doi: 10.1016/0002-8703(81)90379-3. [DOI] [PubMed] [Google Scholar]
  3. Baker K. M., Johns D. W., Ayers C. R., Carey R. M. Ischemic cardiovascular complications concurrent with administration of captopril. A clinical note. Hypertension. 1980 Jan-Feb;2(1):73–74. doi: 10.1161/01.hyp.2.1.73. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. V., Kirk E. S. Differential response of large and small coronary arteries to nitroglycerin and angiotensin. Autoregulation and tachyphylaxis. Circ Res. 1973 Oct;33(4):445–453. doi: 10.1161/01.res.33.4.445. [DOI] [PubMed] [Google Scholar]
  5. Cohn J. N. Relationship of plasma volume changes to resistance and capacitance vessel effects of sympathomimetic amines and angiotensin in man. Clin Sci. 1966 Apr;30(2):267–278. [PubMed] [Google Scholar]
  6. Davis R., Ribner H. S., Keung E., Sonnenblick E. H., LeJemtel T. H. Treatment of chronic congestive heart failure with captopril, an oral inhibitor of angiotensin-converting enzyme. N Engl J Med. 1979 Jul 19;301(3):117–121. doi: 10.1056/NEJM197907193010301. [DOI] [PubMed] [Google Scholar]
  7. Dzau V. J., Colucci W. S., Williams G. H., Curfman G., Meggs L., Hollenberg N. K. Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N Engl J Med. 1980 Jun 19;302(25):1373–1379. doi: 10.1056/NEJM198006193022501. [DOI] [PubMed] [Google Scholar]
  8. Forrester J. S., Ganz W., Diamond G., McHugh T., Chonette D. W., Swan H. J. Thermodilution cardiac output determination with a single flow-directed catheter. Am Heart J. 1972 Mar;83(3):306–311. doi: 10.1016/0002-8703(72)90429-2. [DOI] [PubMed] [Google Scholar]
  9. Ganz W., Tamura K., Marcus H. S., Donoso R., Yoshida S., Swan H. J. Measurement of coronary sinus blood flow by continuous thermodilution in man. Circulation. 1971 Aug;44(2):181–195. doi: 10.1161/01.cir.44.2.181. [DOI] [PubMed] [Google Scholar]
  10. Gavras H., Brunner H. R., Turini G. A., Kershaw G. R., Tifft C. P., Cuttelod S., Gavras I., Vukovich R. A., McKinstry D. N. Antihypertensive effect of the oral angiotensin converting-enzyme inhibitor SQ 14225 in man. N Engl J Med. 1978 May 4;298(18):991–995. doi: 10.1056/NEJM197805042981803. [DOI] [PubMed] [Google Scholar]
  11. Gertz E. W., Wisneski J. A., Neese R., Houser A., Korte R., Bristow J. D. Myocardial lactate extraction: multi-determined metabolic function. Circulation. 1980 Feb;61(2):256–261. doi: 10.1161/01.cir.61.2.256. [DOI] [PubMed] [Google Scholar]
  12. Heel R. C., Brogden R. N., Speight T. M., Avery G. S. Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs. 1980 Dec;20(6):409–452. doi: 10.2165/00003495-198020060-00001. [DOI] [PubMed] [Google Scholar]
  13. LOOMIS M. E. An enzymatic fluorometric method for the determination of lactic acid in serum. J Lab Clin Med. 1961 Jun;57:966–969. [PubMed] [Google Scholar]
  14. Levine T. B., Franciosa J. A., Cohn J. N. Acute and long-term response to an oral converting-enzyme inhibitor, captopril, in congestive heart failure. Circulation. 1980 Jul;62(1):35–41. doi: 10.1161/01.cir.62.1.35. [DOI] [PubMed] [Google Scholar]
  15. Mathey D. G., Chatterjee K., Tyberg J. V., Lekven J., Brundage B., Parmley W. W. Coronary sinus reflux. A source of error in the measurement of thermodilution coronary sinus flow. Circulation. 1978 Apr;57(4):778–786. doi: 10.1161/01.cir.57.4.778. [DOI] [PubMed] [Google Scholar]
  16. Neill W. A. Myocardial hypoxia and anerobic metabolism in coronary heart disease. Am J Cardiol. 1968 Oct;22(4):507–515. doi: 10.1016/0002-9149(68)90155-0. [DOI] [PubMed] [Google Scholar]
  17. Turini G. A., Brunner H. R., Gribic M., Waeber B., Gavras H. Improvement of chronic congestive heart-failure by oral captopril. Lancet. 1979 Jun 9;1(8128):1213–1215. doi: 10.1016/s0140-6736(79)91897-x. [DOI] [PubMed] [Google Scholar]

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