Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of captopril in heart failure and hypertension is becoming increasingly accepted. Captopril has a sulphydryl group in its molecular structure. We wondered if this might confer free radical scavenging activity on the drug and have investigated this in an in vitro system. Results show that captopril is a free radical scavenger and we suggest that this action might be relevant in its use in heart failure and other vascular diseases.
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PMID:Captopril: a free radical scavenger. 265 86

The elderly chronic ischemic heart disease (IHK) patients with cardiac failure show a higher activation of the renin-angiotensin-aldosterone system compared to the younger patients. It was noted functional activity of the renin-angiotensin-aldosterone system increases with a progress of the disease (decompensation). Changes occur not only in the basal level of plasma reninactivity and circulating aldosterone concentration, but also the 24 hour rhythm to the side of an increased hormonal level during the evening hours, evidencing thus for disadaption of the renin-angiotensin-aldosterone system and its decreased reliability under conditions of habitual life activity. Administration of the converting enzyme inhibitor, Captopril, has confirmed a pathogenetic role of the renin-angiotensin-aldosterone system in the development of cardiac failure syndrome in the chronic IHK patients as well as verified a new approach in the treatment of this pathology.
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PMID:[Changes in the renin-angiotensin-aldosterone system in elderly patients with chronic ischemic heart disease. 4. The renin-angiotensin-aldosterone system in elderly patients with ischemic heart disease and cardiovascular insufficiency]. 266 67

The effect of captopril on diuretic requirements was assessed in 16 patients with moderate (13 NYHA Class III, 1 NYHA Class II) or severe (3 NYHA Class IV) stable non-oedematous chronic heart failure. The dose of diuretics was halved before captopril was started and follow-up was continued for two months. In all three patients in NYHA Class IV the diuretic dosage had to be increased to a dose close to, or the same as, the original dose of diuretics in order to keep them from congestive heart failure. One patient improved on the new regime but gained 3.5 kg in weight during follow-up. Of the 13 patients with moderate heart failure, seven showed an improvement in symptoms and exercise duration on the combination of captopril and the lower dose of diuretics (mean 6.9 to 12.5 min, P less than 0.001); two patients did not improve and gained 1.7 kg and 2.3 kg in weight, respectively; three patients required the original dose of diuretics to keep them from congestive heart failure and one patient lost weight on the reduced dose of diuretics but showed no improvement clinically or on treadmill exercise testing. Thus captopril does not have a diuretic sparing effect in patients with severe chronic heart failure. Those treated need the original dose of diuretics for maximal symptomatic benefit. Captopril does have a diuretic sparing effect in some patients with moderate chronic heart failure.
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PMID:Captopril and the diuretic requirements in moderate and severe chronic heart failure. 267 May 67

1. The efficacy of captopril and isosorbide dinitrate (ISDN) as adjunctive therapy to digoxin and diuretics in mild heart failure was compared in a double-blind study. 2. Twenty-one patients were randomly allocated to captopril (twice or three times daily) or ISDN. Eighteen patients completed a protocol of placebo run-in, dose titration and maintenance treatment for 3 months. 3. Symptom-limited exercise tolerance, ejection fraction and radionuclide indices of diastolic function estimated by gated blood pool scan did not change with either treatment. 4. Captopril improved functional class (Canadian Cardiovascular Society) and reduced requirements for increased diuretic dosage at both 1 and 3 months of maintenance treatment. Patients treated with ISDN required increased diuretic and did not improve their functional class. Differences between the treatments were significant only for diuretic dosage requirements. 5. We conclude that adjunctive therapy of mild heart failure with captopril administered twice daily provides a diuretic-sparing effect and may improve functional class during 3 months of maintenance treatment.
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PMID:Comparison of the immediate and long-term effects of captopril and isosorbide dinitrate as adjunctive treatment in mild heart failure. 268 37

Capoten was used in the treatment of 28 patients with macrofocal myocardial infarction associated with marked acute cardiac insufficiency. 1.5 hours following intake of 6.25 mg of Capoten the arterial pressure reduced, the general peripheral vascular resistance, left ventricle filling pressure also reduced and this was accompanied by a reduction of rate of cardiac contractions, increase of cardiac ejection. No side effects related to Capoten treatment were observed.
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PMID:[The hemodynamic effect of Capoten in patients with myocardial infarct complicated by heart failure]. 269 89

The authors used Captopril (Tensiomin, Egis Pharmaceuticals, Budapest) therapy in seven patients suffering from chronic heart failure of ischaemic etiology. As controls, seven patients with dilated cardiomyopathy were involved in the study. All 14 patients received digitalis, diuretic, and isosorbide dinitrate therapy but their condition aggrevated in spite of the therapy. The above-mentioned therapy was completed with daily 3 x 12.5-mg or 3 x 25-mg oral Captopril doses. Significant improvement proved by chest X-ray, echocardiography, and clinical data was observed in four of the ischaemic heart disease patients and three of the dilated cardiomyopathic patients. In other two patients each the improvement was temporary, after 6 weeks of therapy deterioration of the disease was observed. Notable change was not observed in response to Captopril in one ischaemic and two primary cardiomyopathic patients. Tensiomin may be considered as one of the drugs of primary importance in the treatment of chronic congestive heart failure.
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PMID:Captopril (Tensiomin) in the treatment of chronic heart failure of ischaemic heart disease patients. 269 19

The purpose of this retrospective study was to consider impaired renal function in patients with severe congestive heart failure after converting enzyme inhibition and to emphasize the characteristics of this population. The study concerned 26 patients (pts), 72.5 +/- 8.1 years old, with a severe congestive heart failure (NYHA Class IV). Before treatment serum creatinine was slightly increased and the introduction of angiotensin converting enzyme inhibitor (ACEI) - Captopril 58.9 +/- 17.3 mg/j or enalapril 9.2 +/- 4.4 mg - impaired renal function from 132.0 +/- 50.7 mumol/l to 183.5 +/- 139.3 mumol/l (n = 26; p less than 0.05). Patients were separated in 3 groups: in group I; 15 pts, serum creatinine remained unchanged under ACEI in despite of the significant decrease of blood pressure (BP); from 140.7 +/- 24.0/82.5 +/- 13.4 to 120.3 +/- 12.8/71.8 +/- 8.7 mmHg (p less than 0.01). The cause of heart failure was an ischemic heart disease (IHD) in 15 patients (chi 2 test, p less than 0.05), a dilated cardiomyopathy in 4 pts and an aortic or mitral valvular regurgitation in 2 pts. In contrast renal function was significantly impaired in group II; serum creatinine increased from 120.8 +/- 25.2 to 189.0 +/- 80.7 mumol/l under ACEI. BP remained unchanged 136.9 +/- 29.0/78.1 +/- 4.9 and 118.7 +/- 13.6/75.6 +/- 7.6 mmHg respectively before and after treatment. There was 4 pts with dilated cardiomyopathy, 4 pts with mitral or aortic valvular regurgitation and only one with IHD. The introduction of an ACEI in two pts--group III--with severe tricuspid regurgitation induced an acute and reversal renal failure (serum creatinine at 600 mumol/l).
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PMID:[Renal insufficiency and treatment of persistent cardiac insufficiency with converting enzyme inhibitor]. 273 17

Oral inhibitors of angiotensin converting enzyme (ACE) now have an established place in the treatment of hypertension and heart failure. Captopril, the first of these agents, was initially used in high doses and was associated with adverse effects including proteinuria, skin rash and taste disturbance. We report 11 patients who developed side effects during captopril therapy (proteinuria two, rash four, taste disturbance four and taste disturbance with rash one) who were subsequently treated with enalapril, a second generation angiotensin converting enzyme inhibitor. Proteinuria did not recur in either patient, skin rash resolved in all five cases and taste disturbance resolved in four of five during enalapril therapy. We conclude that the side effects of proteinuria, skin rash and taste disturbance are consequences of captopril idiosyncrasy rather than inhibition of the angiotensin converting enzyme. The reported incidence of these side effects with the current recommended dosage of captopril is low.
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PMID:Lack of cross sensitivity between captopril and enalapril. 284 55

Captopril alone as therapy for mild heart failure was compared with a combination of frusemide and amiloride in a double-blind randomised crossover trial in 14 patients who had previously been treated with diuretics. Although 10 patients remained stable on captopril alone, 4 patients deteriorated, with the development of pulmonary oedema of breathlessness. All 4 patients had had pulmonary oedema previously, unlike the patients who remained stable. Angiotensin converting enzyme inhibition alone is not sufficient treatment for patients with mild heart failure and a history of overt pulmonary oedema.
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PMID:Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. 288 42

The maximal aerobic exercise capacity of patients with chronic heart failure is frequently decreased because of inadequate blood flow to working skeletal muscle. To investigate whether this reduced flow is in part due to interference by angiotensin II with arteriolar dilation in working muscle, the effect of the angiotensin-converting enzyme inhibitor captopril on leg blood flow, leg vascular resistance, leg oxygen consumption (VO2) and leg lactate release during maximal upright bicycle exercise was examined in 12 patients with heart failure (maximal VO2 10.7 +/- 3.1 ml/min per kg). Captopril decreased leg resistance at rest (258 +/- 115 to 173 +/- 67 U, p less than 0.01) and maximal exercise (68 +/- 69 to 45 +/- 29 U, p less than 0.01) associated with proportionately similar decreases in systemic vascular resistance. However, maximal exercise duration and maximal VO2 were unchanged and, at identical peak exercise work times, there was no improvement in leg blood flow (2.0 +/- 0.9 to 2.0 +/- 1.1 liters/min, p = NS), leg VO2 (261 +/- 104 to 281 +/- 157 ml/min, p = NS) or leg lactate release (269 +/- 149 to 227 +/- 151 mg/min, p = NS). These data suggest that, during exercise in patients with heart failure, angiotensin II does not interfere with blood flow to working skeletal muscle.
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PMID:Effect of the renin-angiotensin system on limb circulation and metabolism during exercise in patients with heart failure. 299 96


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