Captopril in heart failure. A double blind controlled trial.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Severe congestive heart failure (CHF) presents significant challenges in long-term management.
• Converting enzyme inhibitors offer a potential therapeutic avenue for CHF.
• Understanding the long-term effects of captopril in severe CHF is crucial.

Purpose of the Study:

• To investigate the long-term effects of captopril in patients with severe congestive heart failure.
• To assess the impact of captopril on કાર્ડियोवैस्कुलर hemodynamics, renal function, and hormonal profiles.
• To evaluate the efficacy and safety of captopril in improving symptoms and cardiac dimensions.

Main Methods:

• A double-blind trial involving 14 patients with severe congestive heart failure.
• Administration of captopril as a long-term treatment.
• Monitoring of plasma hormone concentrations (angiotensin II, noradrenaline, renin), renal function (effective renal plasma flow, glomerular filtration rate, renal vascular resistance), electrolytes (potassium, sodium), exercise tolerance, cardiac dimensions, and ventricular arrhythmias.

Main Results:

• Captopril reduced angiotensin II and noradrenaline, increased active renin, improved renal plasma flow, and decreased renal vascular resistance.
• Glomerular filtration rate remained unchanged, while serum urea and creatinine increased.
• Significant improvements were observed in exercise tolerance, reduced dyspnoea and fatigue, decreased left ventricular dimensions, and fewer ventricular ectopic rhythms.
• Adverse effects were minimal, including transient weight gain, fluid retention, postural dizziness, and a slight reduction in white blood cell count.

Conclusions:

• Captopril demonstrates considerable value in the long-term management of severe congestive heart failure.
• The drug effectively modulates the renin-angiotensin system and improves cardiac function and patient symptoms.
• Long-term captopril therapy is generally well-tolerated with a favorable safety profile in this patient group.