| Autor: |
PACHER, R., GLOBITS, S., BERGLER-KLEIN, J., TEUFELSBAUER, H., WUTTE, M., BAUMGARTNER, W., OGRIS, E., GLOGAR, D. |
| Zdroj: |
European Heart Journal; Feb1993, Vol. 14 Issue 2, p273-278, 6p |
| Abstrakt: |
Although angiotensin converting enzyme inhibitor therapy is an established approach in the treatment of chronic heart failure, the required dosage remains unclear. This open 6 month study investigated the influence of different captopril dosages on the clinical course and neurohumoral activity of patients with severe heart failure (left ventricular ejection fraction ≤ 20%). Eighty-five patients in New York Heart Association class II-IV despite treatment with digitalis, diuretics, and captopril (mean dose ± SEM 28±2 mg. day at baseline) for ≥ 3 months received either ‘low dose’ captopril (<75mg. day, mean 32±2 mg. day; n = 46) or ‘high dose’ captopril(≥ 75mg. day,mean99±4 mg. day; n = 39) during the follow-up period. Both groups were comparable in clinical, haemodynamic and neurohumoral parameters at baseline. Functional state improved significantly only in the high dose group ( <0.0001). Of 31 low dose and 20 high dose patients considered as heart transplantation candidates at baseline, 21 low dose and only six high dose patients remained on the waiting list ( <0.0001). In patients in the low dose group, eight deaths were observed ( <0.001). Seven patients remained on low dose captopril due to adverse effects. The initially elevated plasma levels of aldosterone and atrial natriuretic peptide decreased sign only in high dose patients ( <0.01). Renin increased significantly in both groups. These observations underline the necessity of suppressing neurohumoral overactivation with adequate doses of captopril reflected by sequential humoral plasma determination. [ABSTRACT FROM PUBLISHER] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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