ANGIOTENSIN-CONVERTING ENZYME-INHIBITION AND RADIAL ARTERY COMPLIANCEIN PATIENTS WITH CONGESTIVE-HEART-FAILURE

Citation
C. Giannattasio et al., ANGIOTENSIN-CONVERTING ENZYME-INHIBITION AND RADIAL ARTERY COMPLIANCEIN PATIENTS WITH CONGESTIVE-HEART-FAILURE, Hypertension, 26(3), 1995, pp. 491-496
Citations number
58
Categorie Soggetti
Cardiac & Cardiovascular System
Journal title
ISSN journal
0194911X
Volume
26
Issue
3
Year of publication
1995
Pages
491 - 496
Database
ISI
SICI code
0194-911X(1995)26:3<491:AEARAC>2.0.ZU;2-M
Abstract
Congestive heart failure is characterized by a clear-cut impairment of arterial compliance of medium-sized arteries, but whether this altera tion is irreversible or can be favorably affected by cardiovascular dr ugs currently used in congestive heart failure treatment is unknown. W e studied 9 congestive heart failure patients (New York Heart Associat ion class II; age, [mean+/-SEM] 60.7+/-3.3 years) receiving diuretic a nd digitalis treatment in whom arterial compliance was assessed at the level of the radial artery by an echotracking device capable of measu ring the arterial diameter along the entire cardiac cycle. Beat-to-bea t arterial blood pressure was concomitantly measured by a Finapres dev ice that allowed diameter-pressure curves and compliance-pressure curv es (Langewouters' formula) to be calculated for the entire systolic-di astolic blood pressure range. Arterial compliance was expressed as the area under the compliance-pressure curve normalized for pulse pressur e (compliance index). Data were collected before and after 4 and 8 wee ks of oral administration of benazepril (10 mg/day). Ten healthy subje cts were studied before and after an observational period of 4 weeks ( 5 subjects) or 8 weeks (5 subjects), and 9 age-matched mildly essentia l hypertensive subjects studied before and after 4 to 12 weeks of bena zepril administration served as control subjects. In congestive heart failure patients, baseline compliance index was significantly less tha n in normotensive and hypertensive subjects. However, the compliance i ndex showed a marked increase after 4 weeks of benazepril administrati on (+95.7+/-24.9%, P<.05); the increase was also marked after 8 weeks of angiotensin-converting enzyme inhibitor treatment (+77.7+/-4.2%, P< .05). At this time the compliance values of the congestive heart failu re patients were not different from those of the healthy and hypertens ive groups, in which the Observational period and angiotensin-converti ng enzyme inhibitor administration, respectively, had brought no chang e in compliance. Similar results were observed when compliance index w as calculated for the blood pressure range shared by the three groups (isobaric compliance). These data provide the first evidence that the impairment of arterial compliance occurring in congestive heart failur e can be favorably affected by the addition of an angiotensin-converti ng enzyme inhibitor to the treatment regimen. This has favorable impli cations for the cardiovascular functions adversely affected by a reduc ed arterial compliance leg, cardiac work and oxygen consumption, coron ary perfusion, and arterial baroreflex).