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[Treatment of mild and moderate cardiac failure with captopril. A multicenter study]
M Batlouni1, A C Barretto, D Armaganijan
1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP.
Insights
Adding captopril to standard congestive heart failure (CHF) treatment significantly improved patient functional class. This therapy demonstrated good tolerability with uncommon side effects in patients with moderate to severe CHF.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Congestive heart failure (CHF) affects millions globally, impacting quality of life.
- Conventional therapies include digitalis and diuretics but often require augmentation for optimal outcomes.
Purpose of the Study:
- To evaluate the clinical efficacy of adding captopril to conventional therapy for patients with New York Heart Association (NYHA) functional class II and III CHF.
- To assess the impact on heart rate, blood pressure, and overall functional capacity.
Main Methods:
- A 12-week study involving 115 patients with CHF (class II and III) on digitalis and diuretics.
- Captopril dosage was gradually increased from 12.5 mg to 75 mg daily.
- Clinical assessments and laboratory tests were conducted every four weeks.
Main Results:
- Captopril addition significantly reduced heart rate, systolic, and diastolic blood pressure (p < 0.01).
- Functional class improved in 85.2% of patients, with a notable shift from class III/II to class I/II.
- Reported side effects like dizziness and cough were mild and did not necessitate treatment discontinuation.
Conclusions:
- Captopril is a well-tolerated addition to conventional therapy for class II and III CHF.
- This combination therapy leads to significant improvements in functional capacity and hemodynamic parameters.
Purpose:
Evaluation of the clinical effects of captopril addition to the conventional therapy of functional class II and III (NYHA) congestive heart failure (CHF).
Methods:
One hundred and fifteen patients with CHF, 46 (40%) class II and 69 (60%) class III, on conventional treatment (digitalis and diuretic) were the subject of this study. The age ranged from 22 to 75 years (mean 56.6 +/- 11); 67 were male and 66 were caucasians. The etiologies of the heart failure were: hypertensive heart disease 47 (40.9%), ischemic heart disease 27 (23.5%), Chagas cardiomyopathy 20 (17.4%), idiopathic cardiomyopathy 15 (13.0%), and other causes 6 (5.2%). Diuretic and digitalis were maintained in the same dosage during all the treatment. Captopril therapy was started with 6.25 mg b.i.d. or t.i.d., and the dosage was increased gradually to 25 mg b.i.d. or t.i.d. The duration of the study was 12 weeks. Clinical visits occurred every four weeks and laboratory tests were performed in the beginning and at the end of the study.
Results:
The dosage of captopril ranged from 12.5 to 75 mg (mean 28.5 +/- 13.1 mg/day). The addition of captopril to the conventional therapy of CHF was associated with significant reduction (p < 0.01) of heart rate, systolic and diastolic blood pressure. In the end of the study 13 patients (11.3%) were in functional class III, 50 (43.5%) in class II and 52 (45.2%) in class I. Globally, functional class was improved in 98 (85.2%) patients and remained unchanged in 17 (14.8%) (p < 0.01). The side effects (dizziness, cough, hypotension and headache) were moderate and uncommon and did not need interruption of the treatment.
Conclusion:
The addition of captopril to the conventional therapy of class II and III CHF was associated with significant improvement of functional class and with good tolerability.