OBJECTIVE: Angiotensin-converting enzyme inhibitors are an effective therapy for all stages of @entity712 due to reduced systolic left ventricular function. Because sufficient data on intravenous angiotensin-converting enzyme inhibitors following coronary artery bypass surgery complicated by postoperative left @entity67 are unavailable, the efficacy and safety of intravenously administered enalaprilat were evaluated. DESIGN: A placebo-controlled, randomized, double-blind protocol. SETTING: Postoperative intensive care unit at the German Heart Institute Berlin. @entity1 : Forty @entity1 with a left ventricular ejection fraction <35% following coronary artery bypass surgery on the second postoperative day or after weaning from @entity2333 . INTERVENTIONS: A loading dose of enalaprilat 0.625 mg infused over 1 hr was followed by 5 mg/24 hrs administered continuously for up to 72 hrs. MEASUREMENTS AND MAIN RESULTS: Systemic and pulmonary hemodynamic variables, blood gases, hormonal variables, renal function, and electrolytes were measured before and repeatedly during therapy. Acute effects were as follows: At 1 hr, enalaprilat increased the cardiac index (p <.001), @entity64 volume index (p <.001), and right @entity64 work index (p <.03) compared with placebo, whereas mean arterial pressure (p <.008) and both systemic (p <.001) and pulmonary (p <.02) vascular resistance decreased. Continuous effects were as follows: Over 72 hrs, enalaprilat decreased diastolic pulmonary artery pressure (p <.019), pulmonary artery occlusion pressure (p <.02), and central venous pressure (p <.02). The cardiac and @entity64 volume indexes were consistently higher in the enalaprilat group, whereas systemic and pulmonary vascular resistances were lower. The arterial blood-pressure lowering effect was blunted and heart rate remained unchanged. Mixed venous oxygenation (p <.02) was higher and arterial oxygenation was not modified. Finally, enalaprilat increased @entity1011 clearance (p <.002) and decreased @entity1011 (p <.02) and @entity1133 (p <.03). CONCLUSIONS: Intravenous enalaprilat safely and effectively improves cardiac and renal function following coronary artery bypass surgery complicated by postoperative left @entity67 .

Beneficial hemodynamic and renal effects of intravenous enalaprilat following coronary artery bypass surgery complicated by left XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity64 :: ('MESH:D020521', 'Disease') :: ['ventricular stroke', 'stroke'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity1133 :: ('MESH:D014508', 'Chemical') :: ['urea'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity2333 :: ('MESH:D001018', 'Disease') :: ['intra-aortic balloon counterpulsation'] @entity67 :: ('MESH:D018754', 'Disease') :: ['ventricular dysfunction']
@entity67 :: (MESH:D018754,Disease) :: ['ventricular dysfunction']
