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[Decrease in arterial PO2 with captopril administration in secondary pulmonary hypertension and right heart failure].

J Borkenstein1

  • 1Medizinischen Universittsklinik Graz.

Wiener Medizinische Wochenschrift (1946)
|August 15, 1987
PubMed
Summary
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Captopril therapy in patients with chronic obstructive lung disease and pulmonary hypertension did not worsen ventilation-perfusion mismatch. However, all patients experienced decreased oxygen levels due to reduced right heart stroke volume.

Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Context:

  • Secondary pulmonary hypertension and right heart failure in chronic obstructive lung disease (COPD) patients.
  • Limited understanding of captopril's effects on gas exchange in this population.

Purpose:

  • To evaluate the impact of captopril on ventilation-perfusion (V/Q) matching and oxygenation in COPD patients with secondary pulmonary hypertension and right heart failure.

Summary:

  • Captopril therapy was administered to 14 patients with COPD, secondary pulmonary hypertension, and right heart failure.
  • No cranialization of perfusion or increased V/Q mismatch was observed.
  • A significant decrease in arterial oxygen (O2) levels was noted in all patients, attributed to a reduced stroke volume in the right-to-left shunt.

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Impact:

  • Captopril does not exacerbate V/Q mismatch in this patient group.
  • The observed hypoxemia is linked to hemodynamic changes (decreased stroke volume) rather than direct V/Q impairment.
  • Informs clinical management of COPD patients with right heart failure and pulmonary hypertension receiving ACE inhibitors.