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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
2
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pubmed:dateCreated |
1993-4-15
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pubmed:abstractText |
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 < or = 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-1 at baseline) for > or = 3 months received either 'low dose' captopril (< 75 mg.day-1, mean 32 +/- 2 mg.day-1; n = 46) or 'high dose' captopril (> or = 75 mg.day-1, mean 99 +/- 4 mg.day-1; 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 (P < 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 (P < 0.0001). In patients in the low dose group, eight deaths were observed (P < 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 significantly only in high dose patients (P < 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.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Feb
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pubmed:issn |
0195-668X
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
14
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
273-8
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pubmed:dateRevised |
2007-11-15
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pubmed:meshHeading |
pubmed-meshheading:8449205-Aldosterone,
pubmed-meshheading:8449205-Atrial Natriuretic Factor,
pubmed-meshheading:8449205-Captopril,
pubmed-meshheading:8449205-Female,
pubmed-meshheading:8449205-Follow-Up Studies,
pubmed-meshheading:8449205-Heart Failure,
pubmed-meshheading:8449205-Hemodynamics,
pubmed-meshheading:8449205-Humans,
pubmed-meshheading:8449205-Male,
pubmed-meshheading:8449205-Middle Aged,
pubmed-meshheading:8449205-Renin,
pubmed-meshheading:8449205-Retrospective Studies,
pubmed-meshheading:8449205-Treatment Outcome
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pubmed:year |
1993
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pubmed:articleTitle |
Clinical and neurohumoral response of patients with severe congestive heart failure treated with two different captopril dosages.
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pubmed:affiliation |
Department of Cardiology, University of Vienna, Austria.
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pubmed:publicationType |
Journal Article,
Comparative Study
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