caa a22 4500 477057012 CHVBK 20180405111348.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002280050137 doi (NATIONALLICENCE)springer-10.1007/s002280050137 Adaptive changes in the acute haemodynamic effects of cilazapril during chronic treatmentComparison with long-term clinical effect [Elektronische Daten] Comparison with long-term clinical effect [J. Larsen, R. Sykulski, G. Jensen, L. Dössegger, B. Trimarco, T. Moccetti, D. Glogar, A. Schelling, A. H. Bosma] Objective: To study the adaptive changes in the acute haemodynamic response to ACE inhibition during chronic treatment in CHF. Methods: The acute and chronic effects of oral cilazapril (CLZ) treatment, an ACE-inhibitor with prolonged duration on haemodynamic measures (PCWP, PAP, RAP, CI and SVR) and clinical parameters (Quality-of-Life and NYHA class) were investigated in a double-blind, randomised, placebo-controlled trial in CHF. One hundred and thirty five patients (112 completing) in NYHA Classes II-III, on digitalis and diuretic treatment, were randomised after 2 weeks of placebo run-in, to receive either placeabo or CLZ 0.5 mg, 1.0 mg or 2.5 mg daily for 12 weeks, followed by 2 week placebo wash-out. Haeamodynamic studies, including exercise tests before and 3 h after medication, were performed on the first and last days of treatment. Measurements were performed at rest and at the maximum exercise level. Results: In ACEI-naive patients oral CLZ 0.5 and 1 mg/d caused a dose dependent decrease in PCWP and diastolic PAP, and a significant reduction of SVR mg. A slight increase in CI was observed in all groups. The maximum effect was observed 3-5 h post dose. After 12 weeks of oral treatment, the acute response was similar but was attenuated relative to the first dose. Exercise tolerance improved in a dose dependent manner. The NYHA classification remained unchanged or improved in the majority of patients. Entry into the 2.5 mg group had to be terminated at an early stage due to severe adverse events observed after the first dose. Conclusion: During chronic treatment, the haemodynamic response to oral cilazapril was attenuated, indicating that continued clinical improvement in patients with CHF on CLZ is independent of to its acute haemodynamic effects. Springer-Verlag Berlin Heidelberg, 1996 Key words Congestive heart failure nationallicence Cilazapril nationallicence ACE-inhibition nationallicence haemodynamics nationallicence exercise nationallicence long-term nationallicence Larsen J. Department of Cardiology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark, DK aut Sykulski R. Sundby Hospital, D-2300 Copenhagen S, Denmark, DK aut Jensen G. Department of Cardiology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark, DK aut Dössegger L. F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, CH-4002 Basel, Switzerland, CH aut Trimarco B. Fac. di Med, Nuovo Policlinico, Via Pansini 58, I-80131 Napoli, Italy, IT aut Moccetti T. Ospedale Civico, CH-6900 Lugano, Switzerland, CH aut Glogar D. University of Internal Medicine II, Department of Cardiology, Währinger Gürtel 18-20, A-1090 Vienna, Austria, AT aut Schelling A. Sint Franciscus Ziekenhuis, Kleiweg 500, NL-3045 PM, Rotterdam, Netherlands, NL aut Bosma A. H. Sint Joseph Ziekenhuis, Aalsterwfeg 259, NL-5644 RC Eindhoven, Netherlands, NL aut https://doi.org/10.1007/s002280050137 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050137 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Larsen J. Department of Cardiology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Sykulski R. Sundby Hospital, D-2300 Copenhagen S, Denmark, DK aut NATIONALLICENCE 700 1- Jensen G. Department of Cardiology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark, DK aut NATIONALLICENCE 700 1- Dössegger L. F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, CH-4002 Basel, Switzerland, CH aut NATIONALLICENCE 700 1- Trimarco B. Fac. di Med, Nuovo Policlinico, Via Pansini 58, I-80131 Napoli, Italy, IT aut NATIONALLICENCE 700 1- Moccetti T. Ospedale Civico, CH-6900 Lugano, Switzerland, CH aut NATIONALLICENCE 700 1- Glogar D. University of Internal Medicine II, Department of Cardiology, Währinger Gürtel 18-20, A-1090 Vienna, Austria, AT aut NATIONALLICENCE 700 1- Schelling A. Sint Franciscus Ziekenhuis, Kleiweg 500, NL-3045 PM, Rotterdam, Netherlands, NL aut NATIONALLICENCE 700 1- Bosma A. H. Sint Joseph Ziekenhuis, Aalsterwfeg 259, NL-5644 RC Eindhoven, Netherlands, NL aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer