Preliminary Hemodynamic Report of the Efficacy and Safety of Quinapril in Acute and Chronic Treatment of Patients with Congestive Heart Failure

Abstract

A two-part hemodynamic trial of the efficacy and safety of quinapril hydrochloride was conducted in 26 patients with congestive heart failure (NYHA Class III or IV) who had not optimally responded to treatment with diuretics and digitalis. A total of 25 patients had evaluable data after receiving single doses (2.5, 5, or 10 mg) of quinapril. Following acute dosing, favorable hemodynamic changes began within thirty minutes to one hour and usually reached a maximum within four hours post dose. Nineteen evaluable patients who had responded to acute therapy received an additional sixteen weeks of chronic treatment with quinapril in individualized dosage regimens. Hemodynamic responses did not dif fer markedly between acute and chronic therapy. Favorable hemody namic responses were maintained or enhanced following chronic doses of 5 to 30 mg/day (given either once daily or in divided doses). The most fre quent doses were 10-15 mg/day in di vided doses. The mean maximum percent changes in four primary he modynamic parameters after chronic dosing (compared with baseline) were: mean arterial blood pressure, -3.9%; pulmonary capillary wedge pressure, -39.7%; cardiac output, +31.7%; and systemic vascular re sistance, -25.2%. Changes in heart rate and mean arterial blood pres sure did not result in clinically signif icant bradycardia or hypotention. Overall, quinapril produced both acute and sustained beneficial hemo dynamic effects in patients whose congestive heart failure was not clini cally controlled with diuretics and digitalis.