Systemic, pulmonary, brachial, renal and hepato-splanchnic hemodynamic effects of spirapril in severe congestive heart failure.

Abstract

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.

• Authors: E Bellissant, D Annane, E Pussard, C Thuillez, J F Giudicelli
• Journal: Fundamental & clinical pharmacology (Fundam Clin Pharmacol) Vol. 10 Issue 2 Pg. 127-35 ( 1996) ISSN: 0767-3981 [Print] England
• PMID: 8737955 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Enalapril
• spirapril

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Blood Pressure (drug effects)
• Brachial Artery (drug effects, physiology)
• Enalapril (analogs & derivatives, pharmacokinetics, therapeutic use)
• Female
• Heart Failure (drug therapy, physiopathology)
• Hemodynamics (drug effects)
• Humans
• Liver Circulation (drug effects)
• Male
• Middle Aged
• Pulmonary Circulation (drug effects)
• Pulmonary Wedge Pressure (drug effects)
• Renal Circulation (drug effects)
• Vascular Resistance (drug effects)
• Vasodilation (drug effects)