[Hemodynamic effects of intravenous administration of ACE inhibitor in prevention of heart failure following coronary artery bypass surgery].
BACKGROUND
Our study was designed to explore the hemodynamic effects of intravenous administration of ACE-inhibitor quinaprilat in comparison with standard inotropic-vasodilator therapy. Patients with poor left ventricular function following coronary artery bypass (CABG) surgery were examined.


METHODS
Thirty patients with poor left ventricular function (EF<30%) following CABG surgery with use of cardiopulmonaly bypass were examined. Fourty patients were control group. All patients had complete invasive hemodynamic monitoring. The ACE-inhibitor quinaprilat 0.5 mg/h was administered intravenously via infusion pump. The following parameters were analyzed: arterial blood pressure, systemic vascular resistance, pulmonary vascular resistance, heart rate, cardiac output, cardiac index, left ventricular stroke work index and the level of mixed venous oxygen saturation.


RESULTS
The results of our study were as follows: Cardiac output, cardiac index and left ventricular stroke work index were significantly increased in comparison to the control group. Systemic arterial systolic pressure and pulmonary vascular resistance were decreased and there was no significant difference in systemic vascular resistance, mixed venous oxygen saturation, heart rate and diastolic blood pressure in comparison to the control group.


CONCLUSIONS
Our results pointed at very satisfactory hemodynamic effects of quinaprilat on "stunned myocardium", after CABG surgery. The ACE inhibitors greatly reduce mortality in patients in all stages of heart failure, from asymptomatic dysfunction of the left ventricle to severe symptomatic stages.


CONCLUSIONS
In prevention of heart failure in patients with impaired left ventricle function (LVEF<30%), who had undergone CABG surgery with use of cardiopulmonaly bypass, we achieved the best effects on the hemodynamics with parenteral administration of quinaprilat.
Lausević-Vuk
Ljiljana
L
Institut za kardiovaskularne bolesti Dedinje Beograd. florijan@yubc.net
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology
D000806:Angiotensin-Converting Enzyme Inhibitors; D044005:Tetrahydroisoquinolines; C054501:quinaprilat