title: Effects of ramipril on renal function during progressive overpacing-induced heart failure in dogs.
abstract: OBJECTIVE
  To investigate the effects of preventive angiotensin converting enzyme inhibitor treatment with ramipril in dogs with progressively severe experimentally induced heart failure.
  
  
  METHODS
  20 dogs.
  
  
  METHODS
  Dogs were randomly allocated to receive no treatment (control) or ramipril (0.125 mg/kg, PO, daily) for 7 weeks. Physical examination, repetitive catheterization of the right side of the heart, and echocardiography were performed before the study (day 0) and weekly for 7 weeks. Renal plasma flow (RPF) as determined by para-aminohippuric acid clearance and glomerular filtration rate (GFR) as determined by creatinine and iohexol clearances were measured on day 0 and at weeks 4 and 7.
  
  
  RESULTS
  Overpacing induced a progressive increase in right atrial pressure (RAP) and pulmonary artery pressure, occluded (PAPO), with a decrease in systemic arterial pressure. There were progressive alterations of echocardiographic indices of diastolic and systolic ventricular function. The RPF and GFR decreased before cardiac output decreased, and filtration fraction increased. The logarithm of the urinary sodium-to-potassium concentration ratio (log(10)[Na(+)/K(+)]) decreased. Significant effects of ramipril included a delay in clinical signs of heart failure, a late decrease in RAP and PAPO, and increases in the sodium excretion fraction and log(10)(Na(+)/K(+)). There was a satisfactory agreement between the creatinine and iohexol clearance measurements.
  
  
  CONCLUSIONS
  Results suggest that, in this rapid-evolving, dilated cardiomyopathy, activation of the renin-angiotensin system contributes to the pathophysiology of heart failure late in the disease and essentially by an activation of renal salt and water retention.
authors.affiliation: Laboratory of Physiology, Faculty of Medicine, Free University of Brussels, Belgium.
authors.forename: Myrielle
authors.initials: M
authors.lastname: Mathieu
authors.forename: Sophie
authors.initials: S
authors.lastname: Motte
authors.forename: Lynn
authors.initials: L
authors.lastname: Ray
authors.forename: Anne
authors.initials: A
authors.lastname: Pensis
authors.forename: Pascale
authors.initials: P
authors.lastname: Jespers
authors.forename: Serge
authors.initials: S
authors.lastname: Brimioulle
authors.forename: Valérie
authors.initials: V
authors.lastname: Laroute
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mc Entee
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D006333:Heart Failure / Q000662:veterinary*; D008297:Male; D017257:Ramipril / Q000627:therapeutic use*; D012079:Renal Circulation / Q000187:drug effects*; D017595:Renal Plasma Flow / Q000187:drug effects*; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril