Treatment of heart failure associated with acute and chronic forms of ischaemic heart disease by captopril (Tensiomin, EGIS).

The effect of oral Tensiomin treatment, 53.4 mg daily in 29 patients suffering from congestive heart failure associated with acute of chronic forms of ischaemic heart disease, e.g., recent and/or advanced myocardial infarction, aneurysm etc. was studied. The acute and long-term beneficial haemodynamic effects were verified in 4 patients by thermodilution Swan-Ganz catheterization as well. The parameters of ejection function improved moderately, while left ventricular filling pressure (PCW) decreased significantly. The balanced vasodilator effect was not accompanied by an increased myocardial oxygen demand. The "double product" was lowered in response to Tensiomin. During the clinical follow-up (from 6 days to 2 years) there was an improvement in the NYHA functional class by an average of 1.2 however 4 patients died in spite of combined vasodilator and dobutamine treatment. Owing to the improvement of regional blood flow to the brain and the kidney Tensiomin seems to be well-tolerated in patients with low arterial blood pressure. In pts with acute myocardial infarction and angina the critical fall of blood pressure and that of the coronary blood flow should be avoided by giving the drug in approximately titrated. Side effects were observed only with higher doses of Tensiomin in a small number of patients, i.e., transient worsening of renal function in 3 patients and dysgeusia in 2. Our data indicate that Tensiomin treatment is effective and safe in patients suffering from all kinds of congestive heart failure complicating ischaemic heart disease.