Häggström J, Hansson K, Karlberg B E, Kvart C, Madej A, Olsson K
Department of Physiology, Faculty of Veterinary Medicine, University of Agricultural Sciences, Uppsala, Sweden.
Am J Vet Res. 1996 Nov;57(11):1645-52.
To study long-term effects of enalapril, an angiotensin-converting enzyme inhibitor, and hydralazine, an arteriodilator, on renin-angiotensin-aldosterone system and fluid balance before and after administration of furosemide.
22 dogs with clinical signs of congestive heart failure (CHF) attributable to mitral regurgitation.
After initial examination, 12 dogs received enalapril and 10 received hydralazine. Dogs were re-examined 3 weeks and 6 months after initial examination. Furosemide was added after the 3-week examination, and at 6 months, dogs had received furosemide for at least 4 months.
Angiotensin II and aldosterone plasma concentrations were low before treatment, and only aldosterone became significantly decreased after enalapril monotherapy. Concentrations of both hormones and heart rate increased in dogs receiving hydralazine monotherapy, and fluid retention was evident. After long-term treatment with either of the 2 drugs together with furosemide, angiotensin II and aldosterone values increased in both groups. Natriuresis and kaliuresis developed in all dogs, with greatest effect in those receiving enalapril and furosemide. These dogs had decreased plasma sodium concentration, whereas potassium concentration was equally decreased in both groups. After 6 months, the enalapril group, but not the hydralazine group, had increased cardiac size. All dogs had moderate reduction of weight and were azotemic, although changes were more pronounced in those of the hydralazine group.
The 2 drugs have different effects on the renin-angiotensin-aldosterone system and fluid balance in dogs with CHF.
研究血管紧张素转换酶抑制剂依那普利和动脉扩张剂肼屈嗪对服用呋塞米前后肾素-血管紧张素-醛固酮系统及液体平衡的长期影响。
22只患有二尖瓣反流所致充血性心力衰竭（CHF）临床症状的犬。
初次检查后，12只犬接受依那普利治疗，10只犬接受肼屈嗪治疗。初次检查后3周和6个月对犬进行复查。3周检查后加用呋塞米，至6个月时，犬接受呋塞米治疗至少4个月。
治疗前血浆血管紧张素II和醛固酮浓度较低，仅依那普利单药治疗后醛固酮显著降低。接受肼屈嗪单药治疗的犬体内两种激素浓度及心率均升高，且有明显的液体潴留。两种药物之一与呋塞米长期联合治疗后，两组犬的血管紧张素II和醛固酮值均升高。所有犬均出现利钠和利尿作用，以接受依那普利和呋塞米治疗的犬最为明显。这些犬的血浆钠浓度降低，而两组犬的钾浓度均同等程度降低。6个月后，依那普利组犬的心脏大小增加，而肼屈嗪组未增加。所有犬体重均有中度减轻且存在氮质血症，尽管肼屈嗪组犬的变化更为明显。
这两种药物对CHF犬的肾素-血管紧张素-醛固酮系统及液体平衡有不同影响。
