EFFICACY AND SAFETY OF INTRAVENOUS CAPTOPRIL IN CONGESTIVE-HEART-FAILURE

The effect of an intravenous infusion of captopril was evaluated in 13 patients suffering from New York Heart Association class III heart failure. Various hemodynamic and neurohumoral parameters were measured at baseline and during the maximum effect of the intravenous captopril infusion. After the infusion, the time course of effects was observed. The mean cumulative dose of captopril was 10.8 +/- 7 mg. Significant decreases were seen in systolic arterial blood pressure (from 130 to 110 mmHg; P < 0.001), pulmonary wedge pressure (from 18 to 11 mmHg; P < 0.001), and systemic vascular resistance (from 2024 to 1543 dyne/sec/cm-5; P < 0.003). Among the neurohumoral parameters, significant decreases were observed in plasma angiotensin converting enzyme (P < 0.003) and aldosterone (P < 0.004), whereas plasma renin activity increased significantly (P < 0.01). The hemodynamic effects lasted for 80 to 180 minutes and the neurohumoral effects for at least 180 minutes after the captopril infusion was discontinued. No adverse effects were reported. We conclude that intravenous captopril is safe and effective and might provide an alternative to intravenous nitroglycerine, even in intubated patients.