Congestive heart failure (CHF) is a syndrome characterized by increased levels of angiotensin II (Ang II) and endothelin-1 (ET-1). In vitro, Ang II stimulates ET-1 release. The purpose of the study was to assess the effect of a single dose of an angiotensin-converting enzyme inhibitor (ACEI) captopril versus placebo on plasma endothelin concentration in human congestive heart failure. Captopril (25 mg, given orally) was compared with placebo in a group of 20 patients with systolic dysfunction in a double-blind randomized study. Plasma irET concentration was significantly increased in CHF patients compared with normal subjects (5.59 pg/ml +/- 0.35 vs. 3.58 pg/ml +/- 0.99, p < 0.0002). Despite the decrease in systolic blood pressure and the increase in plasma renin activity, suggesting a significant blockade of the renin-angiotensin system, no difference in plasma irET-1 was observed between captopril and placebo. Our results suggest that captopril does not acutely influence irET-1 plasma concentration in human CHF. These data do not support the hypothesis that the acute vasodilator effect of a single dose of 25 mg of captopril given daily orally involves modulation of the increased plasma concentration of endothelin observed in CHF.

译文

充血性心力衰竭(CHF)是一种以血管紧张素II(Ang II)和内皮素1(ET-1)水平升高为特征的综合征。在体外,Ang II刺激ET-1释放。该研究的目的是评估单剂量血管紧张素转换酶抑制剂(ACEI)卡托普利与安慰剂对人充血性心力衰竭血浆内皮素浓度的影响。在一项双盲随机研究中,将卡托普利(25毫克,口服)与20例收缩期功能障碍的患者的安慰剂进行了比较。与正常受试者相比,CHF患者的血浆irET浓度显着增加(5.59 pg / ml /-0.35和3.58 pg / ml /-0.99,p <0.0002)。尽管收缩压降低和血浆肾素活性增加,提示肾素-血管紧张素系统被显着阻断,但卡托普利和安慰剂之间的血浆irET-1没有差异。我们的结果表明,卡托普利不会严重影响人CHF中的irET-1血浆浓度。这些数据不支持这样的假说,即每天口服25 mg卡托普利的单次剂量的急性血管扩张作用涉及调节CHF中所观察到的内皮素血浆浓度的升高。

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