The renin-angiotensin system in refractory heart failure: clinical, hemodynamic and hormonal effects of captopril and enalapril.

Details

Ressource 1Download: serval:BIB_14B1831376C7.P001 (559.70 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_14B1831376C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The renin-angiotensin system in refractory heart failure: clinical, hemodynamic and hormonal effects of captopril and enalapril.
Journal
European Heart Journal
Author(s)
Turini G.A., Waeber B., Brunner H.R.
ISSN
0195-668X
Publication state
Published
Issued date
1983
Peer-reviewed
Oui
Volume
4
Number
Suppl. A
Pages
189-197
Language
english
Notes
licence nationale
Abstract
Studies using a competitive inhibitor of angiotensin II (saralasin) or converting enzyme inhibitors (teprotide, captopril, enalapril) have established that the renin-angiotensin system participates in the control of vascular tone in congestive heart failure both in experimental settings and in patients. In man, the marked decrease in left ventricular filling pressure and the variable increase in stroke volume induced by renin-angiotensin blockade suggests that angiotensin II actively constricts venous as well as arteriolar vascular beds. Captopril, in doses of 25 to 150 mg p.o. TID, maintains its efficacy during chronic administration with persistent clinical and hemodynamic improvement as well as increased exercise tolerance. In our experience, enalapril, 10 mg p.o., improves cardiac function within 4 to 6 h as reflected by a 30% decrease in left ventricular filling pressure, a 28% increase in stroke volume in the face of unchanged heart rate. Clinical improvement, enhanced exercise tolerance and characteristic hormonal responses suggest that enalapril also maintains its efficacy during long-term treatment. Chronic angiotensin II converting enzyme inhibition appears to be a major advance in the treatment of patients with severe congestive heart failure, refractory to digitalis and diuretics.
Keywords
Aldosterone, Angiotensin II, Angiotensin-Converting Enzyme Inhibitors, Captopril, Dipeptides, Enalapril, Epinephrine, Heart Failure, Hemodynamics, Humans, Norepinephrine, Proline, Renin, Renin-Angiotensin System
Pubmed
Web of science
Open Access
Yes
Create date
04/03/2009 15:05
Last modification date
01/10/2019 6:16
Usage data