title: Effect of enalapril maleate on cerebral blood flow in patients with chronic heart failure.
abstract: The effect of enalapril on cerebral blood flow (CBF) was studied in 11 patients with chronic heart failure (NYHA II or III, dilated cardiomyopathy in 6 and old myocardial infarction in 5). CBF was evaluated by analyzing the Patlak-Plot curve obtained from radionuclide angiography with technetium-99m hexamethylpropylene amine oxime (99mTC-HM-PAO). Cardiac index (CI) and stroke volume (SV) were simultaneously measured by impedance cardiography. These measurements were performed before and at four weeks after daily administration of 5 mg enalapril. The stroke volume, cardiac index, and heart rate were not significantly changed after four weeks of enalapril administration. However, CBF was increased by 6.5% from 36.72 +/- 4.66 to 39.13 +/- 5.65 mL/100g/min (P < 0.05). These results suggest that enalapril increased cerebral blood flow, which was not related to increased cardiac output in congestive heart failure. Patlak-Plot analysis of radionuclide angiography using 99mTC-HM-PAO may be available for quantitative assessment of brain perfusion.
authors.affiliation: Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kamishirado
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Fujito
authors.forename: M
authors.initials: M
authors.lastname: Kase
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
authors.forename: K
authors.initials: K
authors.lastname: Takayanagi
authors.forename: S
authors.initials: S
authors.lastname: Morooka
authors.forename: S
authors.initials: S
authors.lastname: Natsui
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002908:Chronic Disease; D004656:Enalapril / Q000494:pharmacology*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011875:Radionuclide Angiography; D013318:Stroke Volume / Q000187:drug effects; D019690:Technetium Tc 99m Exametazime
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D004656:Enalapril