Related Experiment Videos
[Effect of captopril on the life expectancy of patients with chronic heart failure]
1II. Medizinische Abteilung des Städtischen Krankenhauses München-Schwabing.
Insights
This study investigated captopril for advanced congestive heart failure (CHF). Captopril demonstrated efficacy in reducing mortality and morbidity in patients with chronic CHF.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Advanced congestive heart failure (CHF) management has improved with vasodilator therapy, particularly ACE-inhibitors.
- ACE-inhibitors show significant effects on hemodynamics, exercise tolerance, and neuro-endocrine activation in CHF.
- Despite improvements, the overall prognosis for CHF remains poor, with limited correlation between symptoms, hemodynamics, and prognosis.
Purpose of the Study:
- To evaluate the efficacy of captopril in reducing mortality and morbidity in patients with chronic congestive heart failure (CHF).
Main Methods:
- A double-blind, randomized, placebo-controlled trial was conducted.
- Patients with chronic CHF on stable therapy (digitalis and diuretics) were included, using modified Framingham Study criteria.
- Endpoints included death or severe intractable heart failure (NYHA Class IV); follow-up was every three months.
Main Results:
- Captopril demonstrated a powerful influence on hemodynamics and left ventricular hypertrophy.
- The study aimed to assess captopril's impact on mortality and morbidity in chronic CHF patients.
- Patients received captopril at 25 mg twice daily.
Conclusions:
- ACE-inhibitors, like captopril, offer significant benefits in managing congestive heart failure.
- Further analysis is needed to fully elucidate the impact of captopril on CHF outcomes.
Unlabelled:
Since the introduction of vasodilator therapy, progress has been realized in the management of advanced congestive heart failure (CHF) of different etiologies. The most encouraging influences on hemodynamics, exercise tolerance and symptomatology have been reported with ACE-inhibitors. While hemodynamic parameters do correlate with prognosis in CHF [11, 14, 27], the overall prognosis in CHF is very poor [19], and there is no tight correlation between symptomatology, hemodynamics and prognosis [13]. A powerful influence of ACE-inhibitors has been demonstrated not only on hemodynamics and on the neuro-endocrine activation in CHF [10], but also on left ventricular hypertrophy [22] and myocardial morphology [16, 23]. On the background of these therapeutic options, we designed a double-blind, randomized, placebo controlled trial on the efficacy of captopril on mortality and morbidity in chronic CHF. The basic population studied consists of patients of a large community, university-affiliated hospital, with five sub-specialized divisions in internal medicine, and about 600 medical beds. All patients considered for participation live in the greater Munich area.
Inclusion Criteria:
With slight modifications, the criteria used in the Framingham Study were used as entrance criteria [19]. Patients were randomized if they were on stable therapy for their chronic congestive heart failure usually on digitalis and diuretics. Endpoints for the double-blind treatment period were either death or severe (with digitalis and diuretics) untractable heart failure NYHA Class IV. Follow-up examinations comprised office visits of the patients every three months for a precise cardiac history over the last three months based on a questionnaire. Captopril was used in a dose of 25 mg b.i.d.(ABSTRACT TRUNCATED AT 250 WORDS)