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Enalapril for severe heart failure in infancy
M Frenneaux1, R A Stewart, C M Newman
1Department of Cardiology, Hammersmith Hospital, London.
Archives of Disease in Childhood
|February 1, 1989
Summary
Enalapril shows promise in treating severe infant heart failure unresponsive to diuretics. This angiotensin-converting enzyme inhibitor improved clinical symptoms and key biomarkers in infants with heart conditions.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Critical Care Medicine
Background:
- Severe heart failure in infants often presents challenges with conventional treatments.
- Diuretic resistance necessitates exploring alternative therapeutic options for pediatric heart failure.
Purpose of the Study:
- To evaluate the efficacy and safety of enalapril in infants with severe heart failure refractory to diuretics.
- To assess the impact of enalapril on clinical status and biochemical markers in this population.
Main Methods:
- A cohort of eight infants with severe heart failure received enalapril, starting at 0.1 mg/kg/day and titrated based on response.
- Infants had conditions including congenital systemic to pulmonary shunts and aortic coarctation.
- One infant with myocarditis was excluded due to hypotension and subsequent mortality.
Main Results:
- All infants who tolerated enalapril showed clinical improvement in heart failure symptoms within two weeks.
- Mean plasma sodium levels increased significantly (129 to 136 mmol/l).
- Mean plasma urea concentrations decreased substantially (7.0 to 2.9 mmol/l).
Conclusions:
- Enalapril appears to be a potentially beneficial treatment for severe, diuretic-refractory heart failure in infants.
- The drug demonstrated positive effects on clinical status and electrolyte/renal function markers.
- Further investigation into enalapril's role in pediatric heart failure is warranted.