Haemodynamic, hormonal, and electrolyte responses to captopril in resistant heart failure.
In five patients with resistant heart failure treated with the oral converting-enzyme inhibitor, captopril, standardised and intensive haemodynamic, hormone, and electrolyte monitoring showed significantly raised cardiac output and reduced arterial, pulmonary-wedge, and pulmonary-artery pressures which correlated closely with concomitant alterations in the activity of the renin-angiotensin system. These changes occurred in the absence of a natriuresis or diuresis. Clinical improvement was dramatic and paralleled the objective haemodynamic changes. Hyponatraemia and a rise in plasma-potassium were noted. Captopril is a major advance in the treatment of resistant heart failure, and its beneficial haemodynamic effects relate primarily to a blockade of the renin-angiotensin system, the activity of which is increased by conventional drug therapy.
D000368:Aged; D000804:Angiotensin II / Q000097:blood*; D002216:Captopril / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D011392:Proline / Q000031:analogs & derivatives*; D012083:Renin / Q000097:blood*; D012964:Sodium / Q000097:blood*
D000804:Angiotensin II; D011392:Proline; D002216:Captopril; D012964:Sodium; D012083:Renin; D011188:Potassium