This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bengur, A. R. Articles by Rosenthal, A. Search for Related Content PubMed PubMed Citation Articles by Bengur, A. R. Articles by Rosenthal, A.

Circulation, Vol 83, 523-527, Copyright © 1991 by American Heart Association

ARTICLES

Acute hemodynamic effects of captopril in children with a congestive or restrictive cardiomyopathy

AR Bengur, RH Beekman, AP Rocchini, DC Crowley, MA Schork and A Rosenthal
Department of Pediatrics, University of Michigan, Ann Arbor 48109-0204.

The acute hemodynamic effects of captopril were evaluated at cardiac catheterization in 16 children (age, 0.3-18 years) with cardiomyopathy. Twelve children had congestive cardiomyopathy, whereas four had restrictive cardiomyopathy. Hemodynamic measurements were obtained 30 and 60 minutes after the oral administration of captopril (0.5 mg/kg). Blood pressures were measured in the aorta, pulmonary artery, right atrium, and pulmonary capillary wedge position; cardiac outputs were measured by the thermodilution technique. Hemodynamic data could not be obtained after the administration of captopril in one child with congestive cardiomyopathy because of an immediate, severe hypotensive response. In 11 of 12 children with congestive cardiomyopathy, cardiac index increased by 22%, from 2.3 to 2.8 l/min/m2 (p less than 0.05), and stroke volume increased by 22%, from 23 to 28 ml/m2 (p less than 0.05). Systemic vascular resistance decreased from 32 to 21 units.m2 (p less than 0.01), but the mean aortic pressure did not change significantly. In contrast, four children with restrictive cardiomyopathy had no change in cardiac output after captopril, but there was a trend toward significant arterial hypotension (mean aortic pressure decreased from 78 to 59 mm Hg). Thus, captopril acutely reduced systemic vascular resistance and increased both cardiac output and stroke volume in children with congestive cardiomyopathy. In children with restrictive cardiomyopathy, however, captopril did not affect cardiac output, but it did decrease aortic pressure. These data indicate that captopril may benefit children with a congestive cardiomyopathy but that captopril probably should not be used in children with restrictive disease.

This article has been cited by other articles:

				S. E. Lipshultz and S. D. Colan Cardiovascular Trials in Long-Term Survivors of Childhood Cancer J. Clin. Oncol., March 1, 2004; 22(5): 769 - 773. [Full Text] [PDF]

				S. M. Rivenes, D. L. Kearney, E. O'B. Smith, J. A. Towbin, and S. W. Denfield Sudden Death and Cardiovascular Collapse in Children With Restrictive Cardiomyopathy Circulation, August 22, 2000; 102(8): 876 - 882. [Abstract] [Full Text] [PDF]

				V E Hjortdal, E V Stenbøg, H B Ravn, K Emmertsen, K T Jensen, E B Pedersen, K H Olsen, O K Hansen, and K E Sørensen Neurohormonal activation late after cavopulmonary connection Heart, April 1, 2000; 83(4): 439 - 443. [Abstract] [Full Text]

				A. A. Kouatli, J. A. Garcia, T. M. Zellers, E. M. Weinstein, and L. Mahony Enalapril Does Not Enhance Exercise Capacity in Patients After Fontan Procedure Circulation, September 2, 1997; 96(5): 1507 - 1512. [Abstract] [Full Text]