Captopril does not acutely modulate plasma endothelin-1 concentration in human congestive heart failure.
Congestive heart failure (CHF) is a syndrome characterized by increased levels of angiotensin II (Ang II) and endothelin-1 (ET-1). In vitro, Ang II stimulates ET-1 release. The purpose of the study was to assess the effect of a single dose of an angiotensin-converting enzyme inhibitor (ACEI) captopril versus placebo on plasma endothelin concentration in human congestive heart failure. Captopril (25 mg, given orally) was compared with placebo in a group of 20 patients with systolic dysfunction in a double-blind randomized study. Plasma irET concentration was significantly increased in CHF patients compared with normal subjects (5.59 pg/ml +/- 0.35 vs. 3.58 pg/ml +/- 0.99, p < 0.0002). Despite the decrease in systolic blood pressure and the increase in plasma renin activity, suggesting a significant blockade of the renin-angiotensin system, no difference in plasma irET-1 was observed between captopril and placebo. Our results suggest that captopril does not acutely influence irET-1 plasma concentration in human CHF. These data do not support the hypothesis that the acute vasodilator effect of a single dose of 25 mg of captopril given daily orally involves modulation of the increased plasma concentration of endothelin observed in CHF.
Grenier
O
O
Pitié-Salpétrière Hospital, Paris, France.
Pousset
F
F
Isnard
R
R
Kalotka
H
H
Carayon
A
A
Maistre
G
G
Lechat
P
P
Guerot
C
C
Thomas
D
D
Komajda
M
M
D000328:Adult; D000368:Aged; D000804:Angiotensin II / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D004311:Double-Blind Method; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D012083:Renin / Q000097:blood; D013318:Stroke Volume / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D019332:Endothelin-1; D000804:Angiotensin II; D002216:Captopril; D012083:Renin