Dose-Related Hemodynamic Effects of Enalaprilat in Patients with Ischemic Heart Disease

To investigate the dose-related hemodynamic effects of angiotensin-converting enzyme inhibition (ACEI) in patients with angina pectoris (AP), five patients underwent right and left heart catheterization, and left ventriculogram before and 10 min after administration of 1.25 mg enalaprilat intravenously (Group 1). The results were compared with those of five patients with similar characteristics who received 2.5 enalaprilat (Group 2). There were no baseline differences between groups. After enalaprilat administration, there was significant differences between Groups 1 and 2, as follows: systolic blood pressure was 138 plus minus 16 versus 127 plus minus 14 mmHg (p = 0.05), left ventricular end-diastolic pressure was 15 plus minus 6 versus 7 plus minus 4 mmHg (p = 0.04), systemic vascular resistance was 1341 plus minus 290 versus 965 plus minus 271 dyne/sec/cm(minus sign5) (p = 0.05), pulmonary vascular resistance was 174 plus minus 39 versus 156 plus minus 15 dyne/sec/cm(minus sign5) (p = 0.05), end-diastolic volume was 87 plus minus 34 versus 107 plus minus 17 ml (p = 0.03), cardiac index was 3.0 versus 4.5 L min(minus sign1) m(minus sign2) (p = 0.01), left ventricle end-systolic wall stress was 31 plus minus 10 versus 22 plus minus 9 k dyne cm(minus sign5) (p = 0.01), ejection fraction was 69 plus minus 12 versus 81 plus minus 8% (p = 0.01), and wall motion index was 1.14 plus minus 0.1 versus 1.02 plus minus 0.1 (p = 0.001). These results indicate that enalaprilat has dose-related effects improving hemodynamics and ventricular function in patient with AP.