title: [Clinical and hemodynamic efficacy of enalapril in severe congestive heart failure].
abstract: OBJECTIVE
  Evaluate the clinical and hemodynamic efficacy of enalapril in the treatment of severe congestive heart failure, refractory to the classic therapeutics with diuretics and digitalis.
  
  
  METHODS
  Hospitalized patients (pts) of a cardiac department.
  
  
  METHODS
  10 pts with a mean age of 57.8 years in whom a Swan-Ganz catheter was placed for 72 hours to monitor the right pressures and cardiac output, with regular control of arterial blood pressure and cardiac frequency. Low doses of enalapril (2.5 mg) were utilized at the start of the treatment and this dose was readjusted depending on the clinic and hemodynamic parameters.
  
  
  RESULTS
  the 10 pts had the following characteristics: Basal-mean pulmonary arterial pressure (PAP) 34.1 mmHg, Pulmonary wedge pressure (PWP) 21.1 mmHg, cardiac output (CO) 4.8 l/min, cardiac index (CI) 2.8 l/min/m2. After 72 hours with enalapril treatment, these measurements were: PAP-23.8 mmHg, PWP-12.6 mmHg, CO-5.2 l/min and Cl-3.0 ll/min/m2. These differences were statistically significant. With a follow-up of 18.4 months, there was also a clinical improvement; of the 4 pts in class III, 2 moved to class II and 2 to class I; the 4 pts in class IV 4 moved to class II; two pts had died.
  
  
  CONCLUSIONS
  In severe heart failure, the addition of enalapril to the classic therapy has allowed the immediate improvement of the clinical and hemodynamic indexes and this improvement was maintained in the follow-up period.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta.
authors.forename: C
authors.initials: C
authors.lastname: Catarino
authors.forename: J
authors.initials: J
authors.lastname: Serra
authors.forename: E
authors.initials: E
authors.lastname: Antunes
authors.forename: R
authors.initials: R
authors.lastname: Ferreira
authors.forename: N
authors.initials: N
authors.lastname: da Silva
authors.forename: M
authors.initials: M
authors.lastname: de Oliveira
authors.forename: N
authors.initials: N
authors.lastname: Lousada
authors.forename: J
authors.initials: J
authors.lastname: Faria
authors.forename: J
authors.initials: J
authors.lastname: Quininha
authors.forename: R
authors.initials: R
authors.lastname: Gracias
mesh_terms: D000368:Aged; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D004656:Enalapril
vernacular_title: Eficácia clínica e hemodinâmica do enalapril na insuficiência cardíaca congestiva grave.