{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:37:05Z","timestamp":1790419025206,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1981,9]]},"abstract":"<jats:p>The acute effects of the angiotensin converting-enzyme inhibitor captopril on regional blood flow, renal hemodynamics and sodium excretion were studied in 12 patients with severe congestive heart failure. Converting-enzyme inhibition decreased systemic vascular resistance by 27% and increased cardiac index by 16%. Estimated hepatic blood flow decreased 17%, but renal blood flow increased 60%. The ratio of renal-systemic blood flow increased from 0.10 +\/- 0.01 to 0.14 +\/- 0.02 (p = 0.031). Although renal plasma flow increased from 202.8 +\/- 28.8 to 323.7 +\/- 42.7 ml\/min (p less than 0.008), the glomerular filtration rate did not change significantly from the mean pretreatment value of 82.1 +\/- 12.3 ml\/min. The filtration fraction decreased from 41.3 +\/- 3.8% to 33.4 +\/- 4.5% (p = 0.050), while urinary sodium excretion doubled, from 34.5 +\/- 9.6 to 68.2 +\/- 19.6 muEq\/min. The plasma renin activity increased from 12.6 +\/- 5.0 to 29.9 +\/- 8.4 ng\/ml\/hr (p = 0.030) as plasma aldosterone concentration decreased from 30.5 +\/- 6.5 to 11.3 4\/- 1.2 ng\/dl (p = 0.010) and norepinephrine concentrations decreased from 774 +\/- 105 to 618 +\/- 85 pg\/ml (p = 0.020). We conclude that converting-enzyme inhibition reverses renal vasoconstriction in congestive heart failure and redistributes regional blood flow. The natriuresis may be mediated by one or more of the following: improved renal plasma flow, reduction in filtration fraction, suppression of hyperaldosteronism, and lowering of circulatory catecholamine concentrations.<\/jats:p>","DOI":"10.1161\/01.cir.64.3.483","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:29:13Z","timestamp":1308342553000},"page":"483-489","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":144,"title":["Acute regional circulatory and renal hemodynamic effects of converting-enzyme inhibition in patients with congestive heart failure."],"prefix":"10.1161","volume":"64","author":[{"given":"M A","family":"Creager","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J L","family":"Halperin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D B","family":"Bernard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D P","family":"Faxon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C D","family":"Melidossian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Gavras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T J","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.CIR.64.3.483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:19:16Z","timestamp":1715527156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.64.3.483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1981,9]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1981,9]]}},"alternative-id":["10.1161\/01.CIR.64.3.483"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.64.3.483","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1981,9]]},"assertion":[{"value":"1981-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}