Dose-related effects of ACE inhibition in man: quinapril in patients with moderate congestive heart failure. The Study Group on Neurohormonal Regulation in Congestive Heart Failure: Lausanne, Switzerland; Berlin, Dusseldorf, Munich, Germany

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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_C7E8A4A775E7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dose-related effects of ACE inhibition in man: quinapril in patients with moderate congestive heart failure. The Study Group on Neurohormonal Regulation in Congestive Heart Failure: Lausanne, Switzerland; Berlin, Dusseldorf, Munich, Germany
Journal
European Heart Journal
Author(s)
Nussberger J., Fleck E., Bahrmann H., Delius W., Schultheiss H. P., Brunner H. R.
ISSN
0195-668X (Print)
Publication state
Published
Issued date
12/1994
Volume
15 Suppl D
Pages
113-22
Language
english
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Dec
Abstract
Early treatment with ACE inhibitors of even moderate heart failure is clinically beneficial, even though haemodynamic measurements cannot adequately quantitate such improvement. Neurohumoral assessment is, however, supposed to be more accurate. In 55 patients with moderate heart failure (ejection fraction < or = 35%), we investigated the dose-dependent effects of ACE inhibition with quinapril taken orally (2.5, 5 or 10 mg b.i.d.) following a placebo-controlled, parallel design protocol over 12 weeks. Plasma components of the renin angiotensin system, catecholamines and ANF were measured together with haemodynamics both at rest and during exercise. Before ACE inhibitor treatment, median PRA, Ang I and II and catecholamines were normal, while ANF was increased. All these parameters, including ACE activity, rose during exercise. Chronic inhibition of ACE activity was dose-dependent and the maximal fall in Ang II occurred with quinapril 20 mg.day-1. Humoral changes appeared more assessible than haemodynamic alterations even though many of these changes were reasonably correlated. The effects of chronic ACE inhibition on circulating neurohumoral components in patients with moderate heart failure are small and dose-dependent. Since humoral changes are related to haemodynamics they should account for the clinical benefit. Appropriately high doses of ACE inhibitors should be chosen for treatment of heart failure.
Keywords
Administration, Oral Adult Aged Angiotensin-Converting Enzyme Inhibitors/*administration & dosage/adverse effects Dose-Response Relationship, Drug Double-Blind Method Drug Administration Schedule Exercise Test/drug effects Female Heart Failure, Congestive/*drug therapy/physiopathology Hemodynamic Processes/*drug effects/physiology Humans Isoquinolines/*administration & dosage/adverse effects Male Middle Aged Neurotransmitter Agents/blood Renin-Angiotensin System/drug effects/physiology *Tetrahydroisoquinolines Ventricular Function, Left/drug effects/physiology
Pubmed
Web of science
Open Access
Yes
Create date
05/03/2008 17:39
Last modification date
01/10/2019 7:19
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