A pilot placebo-controlled, double-blind, randomised trial was carried out to ascertain whether patients with cardiac failure due to coronary artery disease would benefit further from an additional application of isosorbide-5-mononitrate (IS-5-MN) along with basic Captopril treatment. 21 patients were randomised in this study. Complete haemodynamic data sets of 11 patients in the placebo group and 7 patients in the IS-5-MN group were available for efficacy evaluation. The main target parameter was the mean pulmonary artery pressure (MPAP) during ergometric exercise. After 28 days of treatment with either IS-5-MN or placebo, patients’ MPAP decreased from 43.3 to 35.6mm Hg with IS-5-MN and from 44.2 to 43.8mm Hg in the placebo group under comparable load. Under resting conditions, there was a similar decrease from 27.4 to 22.4mm Hg in the IS-5-MN group and from 26.4 to 25.3mm Hg in the placebo group. The global evaluation of efficacy was judged by the physician as being good in 7 cases in the IS-5-MN group compared with only 1 patient in the placebo group. Two patients in the IS-5-MN group dropped out because of continuous, nonsevere headaches, which were attributed to the use of the test drug.
Adis International Limited Captopril Pulmonary Artery Pressure Drug Invest Wall Tension
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Pfeffer MA, Braunwald E, Lemuel AM, et al. Effect of Captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1992; 327: 669–77PubMedCrossRefGoogle Scholar
Awan NA, Evenson MK, Neddham KE, et al. Efficacy of oral angiotensin converting-enzyme inhibition with Captopril therapy in severe chronic normotensive congestive heart failure. Am Heart J 1981; 101: 22–31PubMedCrossRefGoogle Scholar
Franciosa JA, Mikulic E, Cohn JN, et al. Hemodynamic effects of orally administered isosorbide dinitrate in patients with congestive heart failure. Circulation 1974; 50: 1020–4PubMedCrossRefGoogle Scholar
Olivari MT, Carlyle PF, Levine B, et al. Hemodynamic and hormonal response to transdermal nitroglycerin in normal subjects and in patients with congestive heart failure. J Am Coll Cardiol 1983; 2: 872–8PubMedCrossRefGoogle Scholar
Elkayam U, Roth A, Henriquez B, et al. Hemodynamic and hormonal effects of high-dose transdermal nitroglycerin in patients with chronic congestive heart failure. Am J Cardiol 1985; 56: 555–9PubMedCrossRefGoogle Scholar
Mason DT, Spann JF, Zelis Jr R, et al. Alterations of hemodynamics and myocardial mechanics in patients with congestive heart failure: pathophysiologic mechanism and assessment of cardiac function and ventricular contractility. Prog Cardiovas Dis 1970; 12: 507–57CrossRefGoogle Scholar
Halon DA, Rosenfeld T, Hardoff R. Advantage of combined therapy with Captopril and nitrates in severe congestive heart failure. Isr J Med Sci 1988; 24: 664–70PubMedGoogle Scholar
Debbas N, Woodings D, Marks C, et al. Dose-ranging study of isosorbide-5-mononitrate in chronic congestive heart failure treated with diuretics and angiotensin-converting enzyme inhibito. Am J Cardiol 1988; 61: 28E–30EPubMedCrossRefGoogle Scholar
Münzel T, Heitzer T, Kurz S, et al. Dissociation of coronary vascular tolerance and neurohormonal adjustments during long term nitroglycerin therapy in patients with stable coronary artery disease. J Am Coll Cardiol 1996; 27: 297–303PubMedCrossRefGoogle Scholar