Acute hemodynamic, hormonal and electrolyte effects of ramipril in severe congestive heart failure.

Article Details

Citation

Crozier IG, Ikram H, Nicholls MG, Jans S

Acute hemodynamic, hormonal and electrolyte effects of ramipril in severe congestive heart failure.

Am J Cardiol. 1987 Apr 24;59(10):155D-163D.

PubMed ID
3034025 [ View in PubMed
]
Abstract

The response to ramipril, 10 and 20 mg on consecutive days, in 9 patients with severe (New York Heart Association functional class III or IV) chronic congestive heart failure was measured. Hemodynamic cannulae were placed more than 2 days before ramipril administration to ensure a stable baseline. Dietary sodium (40 mmol daily) and potassium (80 mmol daily) were constant before and during the study, and maintenance doses of digoxin and furosemide (80 to 1,000 mg daily) were continued unchanged. Ramipril induced pronounced, sustained decreases in angiotensin converting enzyme activity, angiotensin II and aldosterone levels, and a reciprocal increase in plasma renin activity. Plasma catecholamines, antidiuretic hormone and cortisol levels were not altered. Urinary sodium and potassium excretion diminished, plasma sodium decreased and plasma potassium increased. Plasma urea and creatinine levels increased. Ramipril treatment resulted in a decrease in systemic arterial pressure that was sustained for 24 hours, a decrease in heart rate and an increase in cardiac index, but little change in pulmonary artery pressure or right atrial pressure. Three patients were drowsy after ramipril administration, and 1 patient had a marked, temporary reduction in urine output. It was concluded that ramipril is a potent, long-acting angiotensin converting-enzyme inhibitor that is likely to be beneficial in patients with severe cardiac failure.

DrugBank Data that Cites this Article

Pharmaco-metabolomics
DrugDrug GroupsMetaboliteChangeDescription
RamiprilApprovedUrea
increased
Ramipril increases the level of Urea in the blood
RamiprilApprovedAldosterone
decreased
Ramipril decreases the level of Aldosterone in the blood
RamiprilApprovedSodium
decreased
Ramipril decreases the level of Sodium in the blood
RamiprilApprovedPotassium
increased
Ramipril increases the level of Potassium in the blood
RamiprilApprovedCreatinine
increased
Ramipril increases the level of Creatinine in the blood