The effects of handgrip stress test on hemodynamic parameters before and after cilazapril treatment in patients with heart failure
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Date
2003
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Abstract
Objective: To assess the effect of cilazapril treatment on several hemodynamic parameters during handgrip manuevers in patients with congestive heart failure. Cilazapril, an ACE inhibitor with high affinity, has been shown to be highly effective against a variety of vascular disorders. The effectiveness of isometric handgrip exercise on changes of cardiovascular hemodynamic parameters before and after cilazapril treatment in patients with congestive heart failure is unknown. Methods: The study population included 30 patients (16 male, 14 female) with mean age of 65±18 years. The effects of handgrip maneuver on hemodynamic parameters were studied by right heart catheterization and Doppler echocardiography. Results: Heart rate (HR) and mean arterial pressures (MAP) increased significantly after handgrip maneuver (from 95±6 beats/min to 101±12 beast/min; from 109±15 mm Hg to 118±19mm Hg, p<0.05 respectively). Pulmonary capillary wedge pressure (PCWP), pulmonary artery systolic (s) and diastolic (d) pressures (PAP), cardiac index (CI), right ventricular systolic and diastolic pressures (RVPs and RVPd), left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF) did not change after handgrip maneuvers (p<0.05). On the other hand, PAPs and PAPd, RVPs and RVPd, MAP and HR (p<0.05) decreased significantly during handgrip maneuvers after cilazapril treatment. However PCWP and CI, LVEF, RVEF did not change after treatment (p<0.05). Conclusion: Cardiovascular response to handgrip maneuver may be a marker of failure to respond to compensatory mechanisms. Cilazapril treatment was associated with significant improvement in hemodynamic parameters during handgrip stress test, the mechanisms of which are increased sympathetic and renin-angiotensin system activation, and altered vascular tonus.
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Adult , Aged , Angiotensin-Converting Enzyme Inhibitors , Cilazapril , Echocardiography, Doppler , Exercise Test , Female , Hand Strength , Heart Failure, Congestive , Hemodynamic Processes , Humans , Male , Middle Aged , cilazapril , digitalis , dipeptidyl carboxypeptidase inhibitor , diuretic agent , nitrate , adult , aged , article , binding affinity , blood vessel tone , cardiovascular parameters , cardiovascular response , clinical article , clinical trial , congestive heart failure , controlled clinical trial , controlled study , diastolic blood pressure , disease marker , Doppler echocardiography , dose response , drug effect , drug efficacy , drug mechanism , exercise test , female , hand grip , heart catheterization , heart index , heart left ventricle ejection fraction , heart rate , heart right ventricle ejection fraction , heart right ventricle pressure , hemodynamic parameters , human , human tissue , isometric exercise , lung artery pressure , lung capillary pressure , male , mean arterial pressure , renin angiotensin aldosterone system , side effect , sympathetic tone , systolic blood pressure , vascular disease