Effects of Captopril on Hemodynamics and Blood Gases in Chronic Obstructive Lung Disease with Pulmonary Hypertension

Abstract

The effects of Captopril, an angiotensin-converting enzyme inhibitor, on pulmonary hemodynamics and blood gases were studied in 9 patients with chronic obstructive lung disease (COLD) and pulmonary hypertension (PAP > 20 mm Hg). Hemodynamic data were recorded prior to Captopril administration (50 mg per os) and for the next 60min. Following Captopril administration, significant reductions in mean pulmonary artery pressure (PAP) (p < 0.05), in mean pulmonary wedge pressure (PWP) (p < 0.05), and in total pulmonary resistance (TPR) were noted; significant reductions in mean brachial artery pressure (BAP) and systemic vascular resistance (SVR) were also recorded, while cardiac output, heart rate and blood gas tensions showed no significant changes. Furthermore, the higher the hypoxemia, the greater was the reduction in BAP (p < 0.05). We therefore feel that Captopril, when administered to COLD patients with pulmonary hypertension, may protect the pulmonary circulation from hypoxic pulmonary vasoconstriction.

Comparative effects of angiotensin II on Doppler parameters of left and right heart systolic and diastolic blood flow.

“…This would produce a worsening of the ventilationperfusion mismatch and hence an increase in pulmonary venous oxygen desaturation. Single-dosing studies with ACE inhibitors have shown variable effects on pulmonary arterial pressure in patients with cor pulmonale [21][22][23]. However, it is probably more meaningful to investigate chronic-dosing effects of ACE inhibitors in terms of haemodynamics, gas exchange and survival [24,25].…”

Effects of Captopril Combined with Oxygen Therapy at Rest and on Exercise in Patients with Chronic Bronchitis and Pulmonary Hypertension

“…The effects of captopril on pulmonary hypertension in chronic obstructive pulmonary disease (COPD) are not yet obvious. In previous works, there was no change in pulmonary hemodynamics after an injection of 50 mg of captopril [8,9] or after 25 mg [10]. Another study showed a decrease in PAP with an increase in cardiac output after 25 mg of captopril 3 times daily for 3 days, associated with low-flow oxygen therapy [11].…”

“…Another study showed a decrease in PAP with an increase in cardiac output after 25 mg of captopril 3 times daily for 3 days, associated with low-flow oxygen therapy [11]. Most of these experiments [8][9][10] are focused on the effects of a single dose at rest. This work addresses the issues of the acute and chronic effects of captopril at rest and on exercise in COPD patients with pulmo nary hypertension.…”

Chronic Beneficial Effects of Type 1 Angiotensin II Receptor Antagonist in Patients with Chronic Hypoxemic Pulmonary Diseases

“…Dear Sir, Angiotensin converting enzyme (ACE) inhibitors have beneficial effects in patients with hypertension, congestive heart failure [1][2][3] and chronic hypoxemic pulmonary diseases [4][5][6].…”

“…Although beneficial effects of ACE inhibitors and acute effects of AIIRA in chronic hypoxemic pulmonary diseases have been reported [4][5][6]10], there is no report on the long-term effects of AIIRA in patients with chronic hypoxemic pulmonary diseases. The present study demonstrates that losartan improved the clinical manifestations, blood pressure and plasma BNP levels in patients with stable but still symptomatic hypoxemic pulmonary disease despite treatment with optimal doses of diuretics, calcium antagonists and steroids.…”