Document Detail

Systemic, pulmonary, brachial, renal and hepato-splanchnic hemodynamic effects of spirapril in severe congestive heart failure.
MedLine Citation:
PMID:  8737955     Owner:  NLM     Status:  MEDLINE    
The effects of a single oral dose (6 mg) of the angiotensin-I converting enzyme inhibitor, spirapril, on systemic, pulmonary and regional (brachial, renal, hepato-splanchnic) hemodynamics as well as on biological parameters investigating the renin-angiotensin-aldosterone and sympathetic nervous systems were studied over a 24-hour period in eight patients with severe congestive heart failure (CHF). As compared to pretreatment values, spirapril significantly decreased mean arterial (-19%, peak effect), right atrial (-42%), mean pulmonary arterial (-38%) and pulmonary capillary wedge (-46%) pressures. Spirapril significantly decreased heart rate (-14%) and increased stroke volume index (+43%) thus resulting in a slight increase in cardiac index. All these effects were maximal between 2.5 and 4 h. Brachial artery diameter (+12%) and brachial (+41%) and renal (+36%) blood flows increased significantly whereas brachial (-41%) and renal (-36%) vascular resistances decreased significantly. All these effects were usually maximal between 1 and 2.5 h. Hepato-splanchnic hemodynamics were not drug-affected. Spirapril significantly inhibited plasma converting enzyme activity (-96% at 4 h), increased plasma renin activity (+505% at 4 h), and decreased plasma aldosterone (-46% at 24 h), norepinephrine (-31% at 24 h) and atrial natriuretic factor (-33% at 7 h). Thus, in severe CHF, acute administration of spirapril, 6 mg orally, exerts both arterial and venous vasodilating properties and improves both the systemic and regional hemodynamics and the biological status of the patients.
E Bellissant; D Annane; E Pussard; C Thuillez; J F Giudicelli
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Fundamental & clinical pharmacology     Volume:  10     ISSN:  0767-3981     ISO Abbreviation:  Fundam Clin Pharmacol     Publication Date:  1996  
Date Detail:
Created Date:  1996-12-06     Completed Date:  1996-12-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8710411     Medline TA:  Fundam Clin Pharmacol     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  127-35     Citation Subset:  IM    
Service de Pharmacologie Clinique, Centre Hospitalier de Bicêtre, Le Kremlin-Bicêtre, France.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Blood Pressure / drug effects
Brachial Artery / drug effects,  physiology
Enalapril / analogs & derivatives*,  pharmacokinetics,  therapeutic use
Heart Failure / drug therapy*,  physiopathology
Hemodynamics / drug effects*
Liver Circulation / drug effects
Middle Aged
Pulmonary Circulation / drug effects
Pulmonary Wedge Pressure / drug effects
Renal Circulation / drug effects
Vascular Resistance / drug effects
Vasodilation / drug effects
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 75847-73-3/Enalapril; 83647-97-6/spirapril

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

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