Comparative systemic and renal effects of dopamine and angiotensin-converting enzyme inhibition with enalaprilat in patients with heart failure

Abstract

Renal and systemic hemodynamics were measured during titration of dopamine and serially after intravenous administration of enalaprilate in nine patients with chronic severe congestive heart failure. During titration of dopamine, renal blood flow increased by 99%, from 304 ± 120 to 604 ± 234 ml/min (p < .05). Mean systemic arterial pressure, however, was greater with dopamine than with enalaprilat (78.1 ± 16.7 vs 70.2 ± 17.2 mm Hg; p < .05) at peak effect. Thus, although both drugs appear to be potent renal vasodilators in patients with severe congestive heart failure, dopamine may be more effective in augmenting renal blood flow.