The Current Therapy of Chronic Heart Failure by Angiotensin Converting Enzyme Inhibitor

Naoyuki TAKEMURA

doi:10.11276/jsvc1984.31.59

Naoyuki TAKEMURA

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Keywords: angiotensin convertiong enzyme inhibitor(ACEI), chronic heart failure, small animal

JOURNAL FREE ACCESS

1998 Volume 31 Issue 2 Pages 59-68

DOI https://doi.org/10.11276/jsvc1984.31.59

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Published: 1998 Received: - Available on J-STAGE: September 17, 2009 Accepted: - Advance online publication: - Revised: -
Correction information
Date of correction: September 17, 2009 Reason for correction: - Correction: ABSTRACT Details: [in Japanese]

Date of correction: September 17, 2009 Reason for correction: - Correction: KEYWORD Details: Wrong : angiotensin convertiong Enzyme inhibitor(ACEI), chronic heart failure, small animal
Right : angiotensin convertiong enzyme inhibitor(ACEI), chronic heart failure, small animal

Date of correction: September 17, 2009 Reason for correction: - Correction: CITATION Details: Wrong : 1) Keen, B. W. and J. E. Rush : Therapy of heart failure. In: Textbook of Veterinary Internal Medicine (4th ed.), Ettinger, S. J. and E. C. Feldman ed., pp. 867-892, W. B. Saunders, Philadelphia, 1995.
2) Sisson, D. (1991): Evidence for or against the efficacy of afterload reducers for management of heart failure in dogs. Vet. Clin. North Am., 21, 945- 955
3) Smith, C. A. (1995): Looking for consensus in treatment of cardiac discase. J Am. Vet. Med. Assoc., 206, 307-312.
4) Fonarow, G. C. and L. W. Stevenson Angiotensin-converting enzyme inhibition in heart. In: Cardiovascular Pharmacology and Thereutics (1st ed.) Singh, B. N., Dzau, V. J., Vanhoutte, P. M. and R. L. Woosley ed., pp.797-814, Churchill Livingstone, New York, 1994.
5) Guyton, A. C. and J. E. Hall : Integration of renal mechanisms for control of blood volume and extracellular fluid volume; and renal regulation of potassium, calcium, phosphate, and magnesium. In: Texbook of Medical Physiology (9th ed.), Guyton, A. C. and J. E. Hall ed., pp.367-383, W. B. Saunders, Philadelphia 1996.
6) Atkins, C. E., Keen, B. W., McGuirk, S. M. and T. Satoh (1994) : Acute effect of hydralazine administration on pulmonary artery hemodynamics in dogs with chronic heartworm disease. Am. J. Vet. Res., 55, 262-269.
7) Kittleson, M. D., Eyster, G. E., Olivier, N.B. and L. K. Anderson (1983): Oral hydralazine therapy for mitral regurgitation in the dog. J. Am. Vet. Med. Assoc., 182, 1205-1209.
8) Kittleson, M. D.,Johnson, L. E. and N. B. Olivier (1985): Acute hemodynamic effects of hydralazine in dogs with chronic mitral regurgitation. J. Am.
Vet. Med. Assoc., 187, 258-261.
9) Smith T. W., Kelly, R. A., Stevenson, L. W. and E. Braunwald : Management of heart failure. In: Heart Disease (5th ed), Braunwald, E. ed., pp.492-514. W. B. Saunders, Philadelphia 1997.
10) Kittleson, M. D.,Johnson, L. E., Pion, P. D. and Y. E. Mekhamer (1993): The acute haemodynamic effects of captopril in dogs with heart failure. J. Vet, Pbaramacol. Ther., 16, 1-7.
11) Hamlin, R. L. and T. Nakayama (1998): Comparison of some pharmacokinetic parameters of 5 angiotensin-converting enzyme inhibitors in normak beagles.j Vet. Intern. Med., 12, 93-95.
12) Koch, J., Pedersen, H. D., Jensen, A. L., Flagstad, A., Poulsen, K. and P. Bie (1994): Short term effects of acute inhibition of the angiotensin-converting enzyme on the renin-angiotensin system and plasma atrial natriuretic peptide in healthy dogs fed a low-sodium diet versus a nor-mal-sodium diet. J. Vet. Med.Assoc., 41, 121-127.
13) Shimoyama, H., Sabbah, H. N., Rosman, H., Kono, T., Alam, M. and S. Goldstein (1995): Effects of long-term therapy with enalapril on severity of functional mitral regurgitation in dogs with moderate heart failure. J. Am. Coll. Cardiol., 25, 768-772.
14) Hamlin, R. L., Benitz, A. M., Ericsson, G. F., Cifelli, S. and C. P. Daurio (1996) : Effects of enalapril on exercise tolerance and longevity in dogs with hesrt failure produced by iatrogenic mitral regurgitation. J. Vet. Intern. Med., 10, 85-87.
15) Ishibashi, T., Tateb, S., Mitomi, A., Tanaka, M. and S. Imai (1991): Hemodynamic effects of benazepril, an angiotensin-converting enzyme inhibitor, as studied in conscious normotensive dogs. Cardiovase. Drugs Ther., 5, 635-642.
16) The COVE Study Group (1995): Controlled clinical evaluation of enalapril in dogs with heart failure: Results of the cooperative veterinary Enalapril study group. J. Vet. Intern. Med., 9, 243- 252.
17) Uehara, Y. and M. Takahashi (1998) : Hemodynamic changes duringes during administration of drugs for mitral regurgitaiton in dogs. J. Vet. Med. Sci., 60, 213-218.
18) Blackford, L. W., Golden, A. L., J. M., Bright, R. M. and R. E. Gompf (1990) : Captopril provides sustained hemodynamic benefits in dogs with experimentally induced mitral regurgitation. Vet. Surg., 19. 237-242.
19) King, J. N., Mauron, C. and G. Kaiser (1995): Pharmacokinetics of the active metabolite of benazepril, benazeprilat, and inhibition of plasma angiotensin-converting enzyme activity after single and repeated administration to dogs. Am. J. Vet. Res., 56, 1620-1628.
20) Kitagawa, H., Wakamiya, H., Kitoh, K., Kuwahara, Y., Ohba, Y., Isaji, M., Iwasaki, T., Nakao, M. and Y. Sasaki (1997) : Efficacy of monotherapy with benazepril, an angiotensin converting enzyme inhibitor, in dogs with naturally acquired chronic mitral insufficiency. J. Vet. Med. Sci., 59, 513-520.
22) Bonagura, J. D. and L. B. Lehmkuhl : Fluid and diuretic therapy in heart failure. In: Fluid Therapy in Small Animal Practie (1st ed.), DiBartola, S. P. ed., pp.529-553, W. B. Saunders, Philadelphia 1992.
23) Schlesinger, D. P. and S. I. Rubin (1994): Potential adverse effects of angiotensin-converting enzyme inhibitors in the treatment of congestive heart failure. Comp. Cont. Edu. Pract. Vet., 16, 275-283.
24) Ljungman, S., Kjekshus, J. and K. Swedberg (1992): Renal function in severe congestive heart failure during treatment with enalapril (The Cooperative North Scandinavian Enalapril Survival Study [CONSENSUS] Trial). Am. J. Caradiol., 70, 479-487.
25) Packer, M., Lee, W.H., Kessler, P. D., Medina, N., Yashak, M., and S. S. Gottlieb (1987): Identification of hyponatremia as arisk factors for the development of functional renal insufficiency during converting enzyme inhibition in severe chronic heart failure. J. Am. Coll. Cardiol., 10, 837-844.
26) Kostis, J. B., Shelton, B., Gosselin, G., Goulet, C., Hood, W. B., Kohn, R. M., Kudo, S. H., Schron, E., Weiss, M. B., Willis, P. W., Young, J. B. and J. Probstfield for the SOLVD investigators (1996): Adverse effects of enalapril in the studies of left ventricular dysfunction(SOLVD). Am. Heart J., 131, 350-355.
27) Packer, M., Lee, W. H., Medina, N., Yushak, M. and P.D. Kessler (1987): Functional renal insufficiency during long-term therapy with captopril and enalapril therapy in severe chronic heart failure. Ann. Intern. Med., 106, 346-354.
28) Fox, P. R. and D. D. Sisson :Angiotensin-converting enzyme inhibitors. In: Kirk's Current Veterinary Therapy XII, Bonagura, J. D. and R. W. Kirk ed., pp. 786-791, W. B. Saunders, Philadelphia, 1995.
29) Bonagura, J. D. and W. A. Ware (1986): Atrial fibrillation in the dog:Clinical findings in 81cases. J.Am. Anlm. Hosp. Assoc., 22, 111-120
30) Cushman, D. W., Wang, F. L., Fung, W. C., Grover, G. J., Harvey, C. M., Scalesr, R. J., Mitch, S.L. and J. M. DeForrest(1989):Comparisons irz vitro, ex vivo, and in vivo of the actions of seven structurally diverse inhibitors of angiotensin con-verting enzyme(ACE). Br. J.Clin.Pbarmaclo, 28, 115S-131S.
31) Lees, K. R.(1992):The dose-response relationship with angiotensin converting enzyme inhibitors:effects on blood pressure and biochemical parameters. J. Hypertens.,10, S3-Sl1.
32) Salvetti, A., Di Venanzio, L., Arrighi, P, and F.
Arzilli (1994): Trough : peak ratio of the blood pressure response to angiotensin converting enzyme inhibitors.J. Hypertens., 12, S91-S95.
33) Nash, D. T. (1992): Comparative properties of angiotensin-converting enzyme inhibitors: Relations with inhibition of tissue angiotensin-converting enzyme and potential alinical implications. Am. J. Cardiol., 69,26C-32C.
34) Cushman, D. W., Wang, F. L., Harvey, C. M. and J. M. DeForrest (1989): Differentiation of angiotensin-converting enzyme
(ACE) inhibitors by their selective inhibition of ACE in physiologi-cally imporyant target organs. Am. J. Hypertens., 2, 294-306.

Right : 1) Keen, B. W. and J. E. Rush : Therapy of heart failure. In: Textbook of Veterinary Internal Medicine (4th ed.), Ettinger, S. J. and E. C. Feldman ed., pp. 867-892, W. B. Saunders, Philadelphia, 1995.
2) Sisson, D. (1991): Evidence for or against the efficacy of afterload reducers for management of heart failure in dogs. Vet. Clin. North Am., 21, 945- 955
3) Smith, C. A. (1995): Looking for consensus in treatment of cardiac discase. J Am. Vet. Med. Assoc., 206, 307-312.
4) Fonarow, G. C. and L. W. Stevenson Angiotensin-converting enzyme inhibition in heart. In: Cardiovascular Pharmacology and Thereutics (1st ed.) Singh, B. N., Dzau, V. J., Vanhoutte, P. M. and R. L. Woosley ed., pp.797-814, Churchill Livingstone, New York, 1994.
5) Guyton, A. C. and J. E. Hall : Integration of renal mechanisms for control of blood volume and extracellular fluid volume; and renal regulation of potassium, calcium, phosphate, and magnesium. In: Texbook of Medical Physiology (9th ed.), Guyton, A. C. and J. E. Hall ed., pp.367-383, W. B. Saunders, Philadelphia 1996.
6) Atkins, C. E., Keen, B. W., McGuirk, S. M. and T. Satoh (1994) : Acute effect of hydralazine administration on pulmonary artery hemodynamics in dogs with chronic heartworm disease. Am. J. Vet. Res., 55, 262-269.
7) Kittleson, M. D., Eyster, G. E., Olivier, N.B. and L. K. Anderson (1983): Oral hydralazine therapy for mitral regurgitation in the dog. J. Am. Vet. Med. Assoc., 182, 1205-1209.
8) Kittleson, M. D.,Johnson, L. E. and N. B. Olivier (1985): Acute hemodynamic effects of hydralazine in dogs with chronic mitral regurgitation. J. Am. Vet. Med. Assoc., 187, 258-261.
9) Smith T. W., Kelly, R. A., Stevenson, L. W. and E. Braunwald : Management of heart failure. In: Heart Disease (5th ed), Braunwald, E. ed., pp.492-514. W. B. Saunders, Philadelphia 1997.
10) Kittleson, M. D.,Johnson, L. E., Pion, P. D. and Y. E. Mekhamer (1993): The acute haemodynamic effects of captopril in dogs with heart failure. J. Vet, Pbaramacol. Ther., 16, 1-7.
11) Hamlin, R. L. and T. Nakayama (1998): Comparison of some pharmacokinetic parameters of 5 angiotensin-converting enzyme inhibitors in normak beagles. J. Vet. Intern. Med., 12, 93-95.
12) Koch, J., Pedersen, H. D., Jensen, A. L., Flagstad, A., Poulsen, K. and P. Bie (1994): Short term effects of acute inhibition of the angiotensin-converting enzyme on the renin-angiotensin system and plasma atrial natriuretic peptide in healthy dogs fed a low-sodium diet versus a normal-sodium diet. J. Vet. Med.Assoc., 41, 121-127.
13) Shimoyama, H., Sabbah, H. N., Rosman, H., Kono, T., Alam, M. and S. Goldstein (1995): Effects of long-term therapy with enalapril on severity of functional mitral regurgitation in dogs with moderate heart failure. J. Am. Coll. Cardiol., 25, 768-772.
14) Hamlin, R. L., Benitz, A. M., Ericsson, G. F., Cifelli, S. and C. P. Daurio (1996) : Effects of enalapril on exercise tolerance and longevity in dogs with hesrt failure produced by iatrogenic mitral regurgitation. J. Vet. Intern. Med., 10, 85-87.
15) Ishibashi, T., Tateb, S., Mitomi, A., Tanaka, M. and S. Imai (1991): Hemodynamic effects of benazepril, an angiotensin-converting enzyme inhibitor, as studied in conscious normotensive dogs. Cardiovase. Drugs Ther., 5, 635-642.
16) The COVE Study Group (1995): Controlled clinical evaluation of enalapril in dogs with heart failure: Results of the cooperative veterinary Enalapril study group. J. Vet. Intern. Med., 9, 243- 252.
17) Uehara, Y. and M. Takahashi (1998) : Hemodynamic changes duringes during administration of drugs for mitral regurgitaiton in dogs. J. Vet. Med. Sci., 60, 213-218.
18) Blackford, L. W., Golden, A. L., J. M., Bright, R. M. and R. E. Gompf (1990) : Captopril provides sustained hemodynamic benefits in dogs with experimentally induced mitral regurgitation. Vet. Surg., 19. 237-242.
19) King, J. N., Mauron, C. and G. Kaiser (1995): Pharmacokinetics of the active metabolite of benazepril, benazeprilat, and inhibition of plasma angiotensin-converting enzyme activity after single and repeated administration to dogs. Am. J. Vet. Res., 56, 1620-1628.
20) Kitagawa, H., Wakamiya, H., Kitoh, K., Kuwahara, Y., Ohba, Y., Isaji, M., Iwasaki, T., Nakao, M. and Y. Sasaki (1997) : Efficacy of monotherapy with benazepril, an angiotensin converting enzyme inhibitor, in dogs with naturally acquired chronic mitral insufficiency. J. Vet. Med. Sci., 59, 513-520.
22) Bonagura, J. D. and L. B. Lehmkuhl : Fluid and diuretic therapy in heart failure. In: Fluid Therapy in Small Animal Practie (1st ed.), DiBartola, S. P. ed., pp.529-553, W. B. Saunders, Philadelphia 1992.
23) Schlesinger, D. P. and S. I. Rubin (1994): Potential adverse effects of angiotensin-converting enzyme inhibitors in the treatment of congestive heart failure. Comp. Cont. Edu. Pract. Vet., 16, 275-283.
24) Ljungman, S., Kjekshus, J. and K. Swedberg (1992): Renal function in severe congestive heart failure during treatment with enalapril (The Cooperative North Scandinavian Enalapril Survival Study [CONSENSUS] Trial). Am. J. Caradiol., 70, 479-487.
25) Packer, M., Lee, W.H., Kessler, P. D., Medina, N., Yashak, M., and S. S. Gottlieb (1987): Identification of hyponatremia as arisk factors for the development of functional renal insufficiency during converting enzyme inhibition in severe chronic heart failure. J. Am. Coll. Cardiol., 10, 837-844.
26) Kostis, J. B., Shelton, B., Gosselin, G., Goulet, C., Hood, W. B., Kohn, R. M., Kudo, S. H., Schron, E., Weiss, M. B., Willis, P. W., Young, J. B. and J. Probstfield for the SOLVD investigators (1996): Adverse effects of enalapril in the studies of left ventricular dysfunction(SOLVD). Am. Heart J., 131, 350-355.
27) Packer, M., Lee, W. H., Medina, N., Yushak, M. and P.D. Kessler (1987): Functional renal insufficiency during long-term therapy with captopril and enalapril therapy in severe chronic heart failure. Ann. Intern. Med., 106, 346-354.
28) Fox, P. R. and D. D. Sisson :Angiotensin-converting enzyme inhibitors. In: Kirk's Current Veterinary Therapy XII, Bonagura, J. D. and R. W. Kirk ed., pp. 786-791, W. B. Saunders, Philadelphia, 1995.
29) Bonagura, J. D. and W. A. Ware (1986): Atrial fibrillation in the dog:Clinical findings in 81cases. J.Am. Anim. Hosp. Assoc., 22, 111-120
30) Cushman, D. W., Wang, F. L., Fung, W. C., Grover, G. J., Harvey, C. M., Scalesr, R. J., Mitch, S.L. and J. M. DeForrest(1989):Comparisons in vitro, ex vivo, and in vivo of the actions of seven structurally diverse inhibitors of angiotensin converting enzyme(ACE). Br. J.Clin.Pharmacol, 28, 115S-131S.
31) Lees, K. R.(1992):The dose-response relationship with angiotensin converting enzyme inhibitors:effects on blood pressure and biochemical parameters. J. Hypertens.,10, S3-S11.
32) Salvetti, A., Di Venanzio, L., Arrighi, P, and F. Arzilli (1994): Trough : peak ratio of the blood pressure response to angiotensin converting enzyme inhibitors.J. Hypertens., 12, S91-S95.
33) Nash, D. T. (1992): Comparative properties of angiotensin-converting enzyme inhibitors: Relations with inhibition of tissue angiotensin-converting enzyme and potential alinical implications. Am. J. Cardiol., 69,26C-32C.
34) Cushman, D. W., Wang, F. L., Harvey, C. M. and J. M. DeForrest (1989): Differentiation of angiotensin-converting enzyme (ACE) inhibitors by their selective inhibition of ACE in physiologically imporyant target organs. Am. J. Hypertens., 2, 294-306.

Abstract

In the present commentary, the clinical use and the associated side effects of angiotensin converting enzyme inhibitors (ACEIs), the cornerstone in the long-term treatment of chronic heart failure (CHF) in the small animal practice, were reviewed. Based on the present author's unpublished data, it was indicated that ACEIs might suppress the progression of CHF when they could be given to a dog with mild hear failure. Incresed blood urea nitrogen (BUN) during chronic angiotensin converting enzyme inhibition was also discussed.

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