[Long-term treatment of severe cardiac insufficiency with captopril].
23 patients with a mean age of 62 +/- 7 years and suffering from a cardiomyopathy with severe chronic heart failure (16 patients in stage IV of the New York Association (NYHA) classification and 7 in stage III NYHA) received long term treatment with captopril (9 patients received 75 mg/day, 9 received 150 mg/day and 5 received 300 mg/day) with a follow-up of 12 +/- 9 months. Following the acute administration of captopril, there was an increase in the cardiac index (Cl) (2.76 +/- 0.56 vs 2.10 +/- 0.4 l . min-1 . m-2, p less than 0.001) between the 4th and 6th hour, a significant decrease in peripheral resistance (PR) (1416 +/- 304 vs 1094 +/- 406 dynes/s/cm-5, p less than 0.001), total pulmonary resistance (TPR) (537 +/- 228 vs 660 +/- 258 dynes/s/cm-5, p less than 0.01) and pulmonary diastolic pressure (PDP) (15.4 +/- 7.2 vs 18.6 +/- mm Hg, p less than 0.001). An early (3rd day) and reversible renal failure caused the treatment to be suspended in one patient. In the 22 other patients, a marked and lasting clinical improvement was obtained (18 patients with stage II NYHA and 4 with stage III NYHA). The beneficial haemodynamic effects persisted until the 4th month in 14 patients (Cl: 2.38 +/- 0.4 vs 2.10 +/- 0.4 l . min-1 . m-2, p less than 0.1; PR: 1828 +/- 314 vs 2054 +/- 406 dynes/s/cm-5, p less than 0.01; TPR: 526 +/- 284 vs 660 +/- 258 dynes/s/cm-5, p less than 0.01; PDP: 16.8 +/- 8.7 vs 18.6 +/- 8.6 mmHg, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D002216:Captopril / Q000627:therapeutic use*; D004341:Drug Evaluation; D004361:Drug Tolerance; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011392:Proline / Q000031:analogs & derivatives*; D013997:Time Factors; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D011392:Proline; D002216:Captopril
Traitement à long terme de l'insuffisance cardiaque sévère par le captopril.