小児心不全患者におけるシラザプリルの効果

概要

論文の詳細を見る
Angiotensin converting enzyme (ACE) inhibitors are effective in the treatment of heart failure, although their pharmacological and precise hemodynamic effects have not yet been well defined in pediatric patients. We attempted to determine an optimal dose of Cilazapril to clarify its cardiovascular effects. We first looked to determine the optimal dose in 20 patients. We found that a dose of 0.04 mg/kg/day reduced ACE activity to less than 50% of baseline measurement, which established this as the optimal dose for pediatric patients. In using the optimal dose as stated above, its short-term effects were studied by means of echocardiography on 13 children with heart failure. It was found that the end-systolic wall stress was significantly reduced, which resulted in an increase in LV pump function. Then, we studied the long-term effect of Cilazapril on 12 children with heart failure. At 1 to 5.3 years after administration, LV pump function had increased and LV diastolic dimension was reduced compared to the baseline data. The cardiovascular effects seen in the short term were maintained for several years and cardiomegaly did not appear in spite of heart failure. The ACE inhibitor, Cilazapril, is therefore an effective medicine for children with heart failure.
東京女子医科大学の論文
2002-12-25