scholarly journals Effect of Angiotensin-converting Enzyme Inhibitors on Phenylephrine Responsiveness in Patients with Valvular Heart Disease

2005 ◽  
Vol 33 (2) ◽  
pp. 150-159 ◽  
Author(s):  
HJ Kwak ◽  
YL Kwak ◽  
YJ Oh ◽  
YH Shim ◽  
SH Kim ◽  
...  
Keyword(s):  
Heart Disease ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Valvular Heart Disease ◽  
Pressor Response ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Control Group ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Significant Difference

We studied patients with valvular heart disease to investigate whether chronic pre-operative treatment with angiotensin-converting enzyme (ACE) inhibitors modulates the effect of phenylephrine (PE) on anaesthesia-induced hypotension. Sixty-five patients were enrolled in the study and hypotension developed after anaesthesia in 36 (18 in the control group and 18 in the ACE inhibitor group). These patients received PE infusions, which were increased in a stepwise fashion at 10-min intervals. Increased mean arterial pressure due to PE infusion was significant only in the control group. There was no significant difference in pressor response or change in haemodynamic variables with PE infusion between the two groups. Treatment with ACE inhibitors did not increase the incidence of hypotensive episodes or significantly modify pressor response after anaesthesia in patients with valvular heart disease.

scholarly journals POTENTIAL OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS IN THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE

2013 ◽  
Vol 12 (1) ◽  
pp. 80-87
Author(s):  
A. G. Evdokimova ◽  
V. V. Evdokimov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angiotensin Converting Enzyme ◽  
Arterial Hypertension ◽  
Ace Inhibitors ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Protective Effects ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

For the last 30 years, angiotensin-converting enzyme (ACE) inhibitors have been playing a key role in the management of arterial hypertension (AH) and related cardiovascular disease. This review discusses the mechanisms of action and organo-protective effects of ACE inhibitors. Enalapril is the most extensively studied and widely used in the international clinical practice ACE inhibitor. The authors analyse the results of the studies on enalapril therapy in AH, coronary heart disease (CHD), chronic heart failure, metabolic syndrome, and postmenopause. It has been demonstrated that the combination antihypertensive therapy with a β-adrenoblocker nebivolol, enalapril, and hydrochlorothiazide (such as Berlipril® Plus) is safe and effective in patients with AH and CHD. 

Endocrinologic Warfare: The Role of Angiotensin-Converting Enzyme Inhibitors in Congestive Heart Failure

1990 ◽  
Vol 3 (5) ◽  
pp. 318-331
Author(s):  
Mark A. Munger ◽  
Stephanie F. Gardner ◽  
Robert C. Jarvis
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Vasodilator Therapy ◽  
The Future

The angiotensin-converting enzyme (ACE) inhibitors represent the gold standard of vasodilator therapy for congestive heart failure through blunting of the endocrinologic manifestations of heart failure. The future role of these agents may be in the asymptomatic and mild stages of heart failure. ACE inhibitors have been shown to decrease morbidity and mortality with the natural history of this disease being altered. The future will bring many new ACE inhibitors to market, with the challenge for physicians and pharmacists to understand the important distinctions of each specific agent. © 1990 by W.B. Saunders Company.

Regional Haemodynamic Effects of Captopril, Enalaprilat and Lisinopril in Conscious Water-Replete and Water-Deprived Brattleboro Rats

1990 ◽  
Vol 79 (4) ◽  
pp. 393-401 ◽  
Author(s):  
A. F. Muller ◽  
S. M. Gardiner ◽  
A. M. Compton ◽  
T. Bennett
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Effective Dose ◽  
Pressor Response ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Haemodynamic Effects ◽  
Converting Enzyme ◽  
Angiotensin I ◽  
Vascular Conductance ◽  
Converting Enzyme Inhibitors ◽  
Renal Flow

1. The regional haemodynamic effects of intravenous bolus doses of captopril, enalaprilat and lisinopril were assessed in conscious Brattleboro (i.e. vasopressin-deficient) rats, chronically instrumented with miniaturized pulsed Doppler probes and intravascular catheters. 2. Responses to incremental doses of each drug (spanning the median effective dose for the inhibition of the pressor response to angiotensin I) were examined in both water-replete and water-deprived states. 3. In the water-replete state, the haemodynamic profiles of captopril, enalaprilat and lisinopril were generally similar, with incremental doses causing rises in mesenteric and renal flow and, to a lesser extent, hindquarters flow. There were small tachycardias and only slight falls in mean blood pressure. 4. In the water-deprived state, the effects of all three drugs were greatly enhanced; tachycardic and hypotensive effects occurred together with increases in mesenteric, renal and hindquarters flows. However, for renal flow and renal vascular conductance the effectiveness of the drugs decreased in the order enalaprilat > captopril > lisinopril, whereas for mesenteric flow and mesenteric vascular conductance the order was captopril > enalaprilat > lisinopril. 5. Since marked haemodynamic actions were seen with doses one-tenth of the median effective dose for the inhibition of the pressor effect of angiotensin I, it is likely these effects were due to inhibition of angiotensin-converting enzyme, although not necessarily to inhibition of angiotensin II production. There were differences between the regional haemodynamic effects of the drugs at higher doses (10 × the median effective dose and 2 mg/kg), these differences supporting the proposition that in future it may be possible to design angiotensin-converting enzyme inhibitors with regionally selective haemodynamic effects.

scholarly journals Cardiotoxicity with antihypertensive drugs (literature review). Part II. Angiotensin converting enzyme inhibitors and multi-drug intoxication

2021 ◽  
pp. 8-14
Author(s):  
A. Yu. Moiseyeva ◽  
A. N. Esaulenko ◽  
A. A. Ivannikov ◽  
I. V. Bratischev ◽  
Kh. G. Alidzhanova
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Antihypertensive Drugs ◽  
Fatal Outcome ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Fixed Dose ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Functional Diagnosis ◽  
Combined Drugs

Overdose with angiotensin converting enzyme (ACE) inhibitors, especially in combination with other cardiovascular drugs, is limited by a small number of publications. A serious problem is an overdose with combined drugs with a fixed dose and poisoning with several drugs at the same time. ACE inhibitors poisoning has serious complications and can lead to a fatal outcome. Acute ACE inhibitors poisoning comes out in disorders of hemocirculation, where one of the predisposing mechanisms of decompensation of blood circulation is the failure of cardiomyocytes, the pathogenesis of which is not fully studied. Therefore, the currently used the methods of cardio- and hemodynamic disorders correction which are currently used do not always give a positive effect. The review highlights the difficulties of clinical and functional diagnosis and treatment of overdose with ACE inhibitors, combined drugs with a fixed dose, as well as poisoning with several drugs.

scholarly journals Medicines in the rehabilitation of patients after myocardial infarction: angiotensin-converting enzyme inhibitors

2010 ◽  
Vol 1 (1) ◽  
pp. 62-64
Author(s):  
A. S Galyavich
Keyword(s):  
Myocardial Infarction ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Ventricular Dysfunction ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

The paper analyzes the use of angiotensin-converting enzyme (ACE) inhibitors in patients after prior myocardial infarction. It presents the data of controlled studies, which indicate that it is warranted to use ACE inhibitors to improve prognosis in patients. It is concluded that it is unreasonable for a physician not to prescribe ACE inhibitors to post-myocardial infarction patients with obvious or asymptomatic left ventricular dysfunction and to diabetic patients (if no contraindications).

scholarly journals Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on the Inflammatory Response and Viral Clearance in COVID-19 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Linna Huang ◽  
Ziying Chen ◽  
Lan Ni ◽  
Lei Chen ◽  
Changzhi Zhou ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Viral Clearance ◽  
Control Group ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Objectives: To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the inflammatory response and viral clearance in coronavirus disease 2019 (COVID-19) patients.Methods: We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:3 was introduced to eliminate potential confounders. Patients were assigned to the ACEI/ARB group (n = 38) or control group (n = 114) according to whether they were current users of medication.Results: Compared to the control group, patients in the ACEI/ARB group had lower levels of plasma IL-1β [(6.20 ± 0.38) vs. (9.30 ± 0.31) pg/ml, P = 0.020], IL-6 [(31.86 ± 4.07) vs. (48.47 ± 3.11) pg/ml, P = 0.041], IL-8 [(34.66 ± 1.90) vs. (47.93 ± 1.21) pg/ml, P = 0.027], and TNF-α [(6.11 ± 0.88) vs. (12.73 ± 0.26) pg/ml, P < 0.01]. Current users of ACEIs/ARBs seemed to have a higher rate of vasoconstrictive agents (20 vs. 6%, P < 0.01) than the control group. Decreased lymphocyte counts [(0.76 ± 0.31) vs. (1.01 ± 0.45)*109/L, P = 0.027] and elevated plasma levels of IL-10 [(9.91 ± 0.42) vs. (5.26 ± 0.21) pg/ml, P = 0.012] were also important discoveries in the ACEI/ARB group. Patients in the ACEI/ARB group had a prolonged duration of viral shedding [(24 ± 5) vs. (18 ± 5) days, P = 0.034] and increased length of hospitalization [(24 ± 11) vs. (15 ± 7) days, P < 0.01]. These trends were similar in patients with hypertension.Conclusions: Our findings did not provide evidence for a significant association between ACEI/ARB treatment and COVID-19 mortality. ACEIs/ARBs might decrease proinflammatory cytokines, but antiviral treatment should be enforced, and hemodynamics should be monitored closely. Since the limited influence on the ACEI/ARB treatment, they should not be withdrawn if there was no formal contraindication.

scholarly journals Interaction of SARS-CoV-2 spike protein with angiotensin converting enzyme inhibitors and selected compounds from the chemical entities of biological interest

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Suleiman Aminu ◽  
Mohammed Auwal Ibrahim ◽  
Abdullahi Balarabe Sallau
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Enzyme Inhibitors ◽  
Initial Step ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Binding Energies ◽  
Spike Protein ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Discovery Studio

Abstract Background Recent COVID-19 outbreak has prompted the search of novel therapeutic agents to treat the disease. The initial step of the infection involves the binding of the virus through the viral spike protein with the host angiotensin converting enzyme 2 (ACE2). In this study, the interaction of some ACE or ACE2 inhibitors and their analogues as well as selected compounds with the viral spike protein as a strategy to hinder viral-ACE2 interaction were investigated. SARS-CoV-2 spike protein as well as the ligands were retrieved from protein databank and ChEBI database respectively. The molecules were prepared before initiating the virtual screening using PyRx software. Discovery studio was used to further visualize the binding interactions between the compounds and the protein. Results The ACE inhibitors and their analogues fosinopril (1-), fosinopril and moexipril have the best binding affinity to the protein with binding energies < − 7.0 kcal/mol while non-flavonoid stilben-4-ol binds with free binding energy of − 7.1 kcal/mol. Others compounds which belong to either the flavonoids, terpenes and alkaloid classes also have binding energies  < − 7.0 kcal/mol. Such high binding energies were enhanced via hydrogen bond (h-bond) interactions in addition to other interactions observed between the compounds and the amino acid residues of the protein. Conclusions The ACE inhibitors and their analogues as well as the selected compounds could serve as inhibitors of the spike protein as well as lead in drug discovery processes to target the SARS-CoV-2 virus.

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