Author/Editor		Podbregar, M; Voga, G; Horvat, M; Žuran, I; Krivec, B; Skale, R; Parežnik, R
Title		Bolus versus continuous low dose of enalaprilat in congestive heart failure with acute refractory decompensation
Type		članek
Source		Cardiology
Vol. and No.		Letnik 91
Publication year		1999
Volume		str. 41-9
Language		eng
Abstract		The first dose of angiotensin-converting enzyme (ACE) inhibitors may trigger a considerable fall of blood pressure in chronic heart failure. The response may be dose-related. To determine hemodynamic and systemic oxygenation effects of low-dose enalaprilat, we administered intravenous enalaprilat (0.004 mg/kg) as bolus (group B) or continuous 1-hour infusion (group C) in 20 patients with congestive heart failure due to ischemic heart disease with acute decompensation refractory to inotropic, vasodilator and diuretic therapy. Hemodynamic and systemic oxygenation variables were recorded at baseline (+0 min), +30, +60, +120, +180, and +360 min after the start of intervention. Mean arterial pressure (MAP) (p<0.001), mean pulmonary artery pressure (MPAP) (p<0.001), pulmonary artery occlusion pressure (PAOP) (p<0.001), oxygen extraction ratio (ER) (p< 0.026) decreased regardless of enalaprilat application. Compared to group B, there was in group C prolonged decrease of MAP, MPAP, PAOP, ER and increase of pulmonary artery oxyhemoglobin saturation in regard to baseline values. Cardiac index, heart rate, central venous pressure and oxygen consumption index did not change. A low dose of intravenous enalaprilat (0.004 mg/kg) can be used to safely improve hemodynamics and systemic oxygenation in congestive heart failure due to ishemic heart disease with acute refractory decompensation.
Descriptors		HEART FAILURE, CONGESTIVE ENALAPRILAT ECHOCARDIOGRAPHY ELECTROCARDIOGRAPHY BLOOD PRESSURE HEART RATE CENTRAL VENOUS PRESSURE OXYGEN CONSUMPTION CORONARY DISEASE CARDIAC OUTPUT ANALYSIS OF VARIANCE