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Enalapril in heart failure.

M G Nicholls, H Ikram, E A Espiner

    British Journal of Clinical Pharmacology
    |January 1, 1984
    PubMed
    Summary
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    Enalapril therapy improved exercise tolerance and clinical status in heart failure patients by reducing angiotensin converting enzyme activity. This study demonstrates enalapril

    Area of Science:

    • Cardiology
    • Pharmacology
    • Biochemistry

    Background:

    • Heart failure management often involves targeting the renin-angiotensin-aldosterone system.
    • Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used in heart failure treatment.
    • Understanding the pharmacokinetic and pharmacodynamic effects of enalapril is crucial for optimizing therapy.

    Purpose of the Study:

    • To evaluate the effect of enalapril on serum MK-422 levels and plasma angiotensin converting enzyme (ACE) activity.
    • To assess the impact of enalapril treatment on exercise tolerance, clinical status, and hemodynamics in heart failure patients.

    Main Methods:

    • Study 1: Measured serum MK-422 and plasma ACE activity in 8 heart failure patients during enalapril therapy initiation.
    • Study 2: Assessed exercise tolerance, clinical status, and hemodynamics in 16 heart failure patients over 12 weeks, comparing enalapril to placebo.

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  • Drug administration involved increasing doses of enalapril (5, 10, 20 mg) with serial measurements.

    • Main Results:

    • Enalapril administration resulted in dose-dependent increases in serum MK-422.
    • Plasma ACE activity was suppressed for at least 24 hours after enalapril dosing.
    • Enalapril treatment group showed improvements in exercise performance, clinical status, and reduced right heart pressures compared to placebo.

    Conclusions:

    • Enalapril effectively inhibits plasma ACE activity and increases serum MK-422.
    • 12 weeks of enalapril therapy demonstrated beneficial effects on functional capacity and hemodynamics in heart failure patients.
    • Enalapril is a valuable therapeutic option for managing heart failure.