Titre
The renin-angiotensin system in refractory heart failure: clinical, hemodynamic and hormonal effects of captopril and enalapril.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Turini, G.A.
Auteure/Auteur
Waeber, B.
Auteure/Auteur
Brunner, H.R.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0195-668X
Statut éditorial
Publié
Date de publication
1983
Volume
4
Numéro
Suppl. A
Première page
189
Dernière page/numéro d’article
197
Peer-reviewed
Oui
Langue
anglais
Notes
licence nationale
Résumé
Studies using a competitive inhibitor of angiotensin II (saralasin) or converting enzyme inhibitors (teprotide, captopril, enalapril) have established that the renin-angiotensin system participates in the control of vascular tone in congestive heart failure both in experimental settings and in patients. In man, the marked decrease in left ventricular filling pressure and the variable increase in stroke volume induced by renin-angiotensin blockade suggests that angiotensin II actively constricts venous as well as arteriolar vascular beds. Captopril, in doses of 25 to 150 mg p.o. TID, maintains its efficacy during chronic administration with persistent clinical and hemodynamic improvement as well as increased exercise tolerance. In our experience, enalapril, 10 mg p.o., improves cardiac function within 4 to 6 h as reflected by a 30% decrease in left ventricular filling pressure, a 28% increase in stroke volume in the face of unchanged heart rate. Clinical improvement, enhanced exercise tolerance and characteristic hormonal responses suggest that enalapril also maintains its efficacy during long-term treatment. Chronic angiotensin II converting enzyme inhibition appears to be a major advance in the treatment of patients with severe congestive heart failure, refractory to digitalis and diuretics.
PID Serval
serval:BIB_14B1831376C7
PMID
Open Access
Oui
Date de création
2009-03-04T14:05:15.926Z
Date de création dans IRIS
2025-05-20T18:15:07Z
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Nom
REF.pdf
Version du manuscrit
published
Taille
559.7 KB
Format
Adobe PDF
PID Serval
serval:BIB_14B1831376C7.P001
URN
urn:nbn:ch:serval-BIB_14B1831376C72
Somme de contrôle
(MD5):fc1b04e5984587059600b42217fcd8ab