PMID- 7511753
OWN - NLM
STAT- MEDLINE
DCOM- 19940505
LR  - 20151119
IS  - 0160-2446 (Print)
IS  - 0160-2446 (Linking)
VI  - 23
IP  - 2
DP  - 1994 Feb
TI  - Effects of acetylsalicylic acid on peripheral hemodynamics in patients with 
      chronic heart failure treated with angiotensin-converting enzyme inhibitors.
PG  - 240-5
AB  - Cyclooxygenase inhibitors may affect the hemodynamic status of patients with 
      heart failure adversely and may also block the vasodilatory effects of 
      angiotensin-converting enzyme (ACE) inhibitors in such patients. Relatively low 
      doses of the cyclooxygenase inhibitor acetylsalicylic acid (ASA) are now used 
      routinely in ischemic heart disease, the most important cause of heart failure. 
      Therefore, we investigated the hemodynamic interaction between ASA and captopril 
      in heart failure. In a randomized, cross-over study, 13 patients with congestive 
      heart failure (CHF) who were already receiving maintenance treatment with an ACE 
      inhibitor received a single dose of 25 mg captopril combined with 236 mg ASA or 
      placebo. Peripheral blood flow was studied noninvasively by venous occlusion 
      plethysmography of the calves. Liver blood flow was estimated from indocyanine 
      green (ICG) clearance. Administration of captopril alone significantly decreased 
      blood pressure (BP), and ICG clearance. Calf blood flow remained unchanged. 
      However, after arterial occlusion, hyperemic calf blood flow persisted for 
      longer. Captopril alone did not significantly change the plasma levels of the 
      vasodilating prostaglandins PGI2 and PGE2 or the vasoconstricting thromboxane A2 
      (TXA2). In contrast, captopril combined with ASA reduced the plasma levels of 
      these vasoactive substances, with significant decreases in PGE2 and TXA2 as 
      compared with captopril alone, yet the hemodynamic alterations after captopril 
      plus ASA were similar to those observed after captopril alone. A single 
      antithrombotic dose of ASA (236 mg) in 13 patients with CHF [New York Heart 
      Association (NYHA) class II-IV] undergoing chronic treatment with ACE inhibitors 
      had no discernible effect on hemodynamic status.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - van Wijngaarden, J
AU  - van Wijngaarden J
AD  - Department of Pharmacology/Clinical Pharmacology, University of Groningen, The 
      Netherlands.
FAU - Smit, A J
AU  - Smit AJ
FAU - de Graeff, P A
AU  - de Graeff PA
FAU - van Gilst, W H
AU  - van Gilst WH
FAU - van der Broek, S A
AU  - van der Broek SA
FAU - van Veldhuisen, D J
AU  - van Veldhuisen DJ
FAU - Lie, K I
AU  - Lie KI
FAU - Wesseling, H
AU  - Wesseling H
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Prostaglandins)
RN  - 9G64RSX1XD (Captopril)
RN  - IX6J1063HV (Indocyanine Green)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Arm/blood supply
MH  - Aspirin/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Captopril/therapeutic use
MH  - Chronic Disease
MH  - Double-Blind Method
MH  - Drug Interactions
MH  - Female
MH  - Heart Failure/blood/drug therapy/*physiopathology
MH  - Hemodynamics/*drug effects
MH  - Humans
MH  - Indocyanine Green
MH  - Leg/blood supply
MH  - Male
MH  - Middle Aged
MH  - Prostaglandins/blood
MH  - Regional Blood Flow/drug effects
EDAT- 1994/02/01 00:00
MHDA- 1994/02/01 00:01
CRDT- 1994/02/01 00:00
PHST- 1994/02/01 00:00 [pubmed]
PHST- 1994/02/01 00:01 [medline]
PHST- 1994/02/01 00:00 [entrez]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 1994 Feb;23(2):240-5.