Martínez Sánchez C, Henne O, Arceo A, Peña M, González H, Chuquiure E, Lupi E
Instituto Nacional de Cardiología Ignacio Chávez. (INCICH. Juan Badiano No.1, 14080, México, D.F.).
Arch Inst Cardiol Mex. 1996 Jul-Aug;66(4):322-30.
To analyse the hemodynamic and ventricular function effects of oral captopril in severe aortic stenosis.
inclusion criteria: patients older than 18 years with critical aortic stenosis.
angiotensin-converting enzyme inhibitor used previously contraindication to right catheterisation aortic insufficiency, valvular prosthesis in aortic position, or other valvulopathy. As well as the need for immediate valvular aortic replacement arrhythmia, A-V conduction alterations, or ventilatory support.
prospective, no randomized. Swan-Ganz catheter was used. Basal hemodynamic measurements were made on 1, 2, 4, 6 and 8 hours during 48 hours. Captopril was administered 12.5 mg first and then 8 mg tid (6 doses).
Neuman-Keuls test was used for multivariate comparisons. Statistical significance was determined with P < 0.05.
22 patients were analyzed. Systemic vascular resistance fell from 1750 Dyn/seg/cm-5 to 1200 (P-0.001), cardiac output increased from 4.1l/min to 5.8 (P-0.001), cardiac index increased from 2.4 l/min/m2 to 2.9 (P-0.009), stroke volume from 47 ml to 64 (P-0.04) and stroke volume index from 27 ml/m2 to 36 (P-0.002). In patients with heart failure (n = 7) the systemic vascular resistance fell from 2050 Dyn/seg/cm-5 to 1463 (P-0.04), cardiac output increased from 2.8l/min to 4.1 (P-0.04), cardiac index from 2.07 l/min/m2 to 2.75 (P-0.04), stroke volume from 46 ml to 64 (P-0.03), pulmonary capillary wedge pressure fell from 19 mmHg to 16 (0.04) and the systolic pulmonary arterial pressure fell from 63 mmHg to 42 (P-0.009).
captopril improves the hemodynamic parameters in patients with critical aortic stenosis, principally in those with heart failure.
分析口服卡托普利对重度主动脉瓣狭窄患者血流动力学及心室功能的影响。
纳入标准：年龄大于18岁的重度主动脉瓣狭窄患者。
既往使用过血管紧张素转换酶抑制剂；右心导管检查禁忌证；主动脉瓣关闭不全、主动脉位置有瓣膜假体或其他瓣膜病变。以及需要立即进行主动脉瓣置换术；心律失常、房室传导改变或通气支持。
前瞻性、非随机。使用Swan - Ganz导管。在48小时内于1、2、4、6和8小时进行基础血流动力学测量。先给予卡托普利12.5mg，然后8mg，每日三次（共6剂）。
采用纽曼 - 基尔斯检验进行多变量比较。以P < 0.05确定统计学显著性。
分析了22例患者。全身血管阻力从1750达因/秒/厘米⁵降至1200（P = 0.001），心输出量从4.1升/分钟增至5.8（P = 0.001），心脏指数从2.4升/分钟/平方米增至2.9（P = 0.009），每搏量从47毫升增至64（P = 0.04），每搏量指数从27毫升/平方米增至36（P = 0.002）。在心力衰竭患者（n = 7）中，全身血管阻力从2050达因/秒/厘米⁵降至1463（P = 0.04），心输出量从2.8升/分钟增至4.1（P = 0.04），心脏指数从2.07升/分钟/平方米增至2.75（P = 0.04），每搏量从46毫升增至64（P = 0.03），肺毛细血管楔压从19毫米汞柱降至16（P = 0.04），收缩期肺动脉压从63毫米汞柱降至42（P = 0.009）。
卡托普利可改善重度主动脉瓣狭窄患者的血流动力学参数，主要是心力衰竭患者。
