Document Detail


Changes in pulmonary hemodynamics predict benefits in exercise capacity after ACE inhibition in patients with mild to moderate congestive heart failure.
MedLine Citation:
PMID:  8370193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Several causes may affect the efficacy of angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure (CHF). The present study was undertaken to identify what factors might predict benefits in exercise capacity after ACE inhibition in 22 patients with mild to moderate CHF. All patients underwent hemodynamic evaluation before and following an oral dose of quinapril (20 mg). They were then treated daily with 20 mg of quinapril and underwent exercise stress test off-drugs 1 day and 6 months later. Patients were grouped according to their relative changes in vascular resistances after quinapril: Group A (n = 15) showed a greater decrease in pulmonary vascular resistance (PVR) than in systemic vascular resistance (SVR) (% delta PVR/% delta SVR > 1). The opposite occurred in Group B (n = 7). Comparison of pretreatment baseline features revealed that the two groups had similar biochemical and hormonal variables, cardiac index, and SVR. Conversely, Group A patients had higher (p < 0.05) pulmonary artery pressure and PVR compared with Group B patients. Following quinapril, Group A patients showed a greater (p < 0.05) increase in cardiac index than Group B patients, despite a similar reduction in SVR. Accordingly, 1-day drug treatment significantly (p < 0.001) increased exercise duration in Group A (+29%), but not in Group B patients (+7%). Benefits in exercise capacity were still significant (p < 0.001) 6 months later.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
F Pelliccia; A Borghi; A Ruggeri; C Cianfrocca; G L Morgagni; R Bugiardini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  16     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-10-14     Completed Date:  1993-10-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  607-12     Citation Subset:  IM    
Affiliation:
Istituto di Patologia Medica, University of Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use*
Atrial Function, Right / drug effects
Blood Pressure / drug effects
Cardiac Output / drug effects
Exercise Test
Exercise Tolerance / physiology*
Female
Heart Failure / drug therapy*,  physiopathology*
Hemodynamics / drug effects
Humans
Isoquinolines / administration & dosage,  therapeutic use*
Lung / physiopathology*
Male
Middle Aged
Pulmonary Artery / drug effects,  physiopathology
Pulmonary Wedge Pressure / drug effects
Stroke Volume / drug effects
Tetrahydroisoquinolines*
Time Factors
Vascular Resistance / drug effects
Vasodilation
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Isoquinolines; 0/Tetrahydroisoquinolines; 82586-55-8/quinapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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