The Hemodynamic Effects of ACE Inhibitors in the Treatment of Congestive Heart Failure

Abstract

To determine the safety and efficacy of single oral doses of quinapril in the treatment of congestive heart failure (CHF), an open-label, hemodynamic trial was conducted in 11 patients with severe CHF [New York Heart Association (NYHA) class III or IV] in whom previous or current therapy with diuretics and digitalis had been inadequate. After participating in this single-dose trial (acute phase), all 11 patients were entered into a 16-week, multiple-dose investigation (chronic phase). In the acute phase of the study, single oral doses of quinapril (2.5, 5, and 10 mg/day) achieved beneficial hemodynamic changes within 1 h after the onset of therapy. Maximal improvements in key hemodynamic variables (i.e., pulmonary capillary wedge pressure, mean arterial blood pressure, cardiac output, and total systemic vascular resistance) were observed within 4 h after dosing. The hemodynamic changes after 16 weeks of chronic quinapril therapy (5, 10, 15, and 30 mg/day) were equivalent or superior to those observed after acute therapy, indicating that quinapril produces a sustained hemodynamic benefit after chronic oral dosing. Quinapril was shown to be safe and effective in the treatment of patients with severe CHF.