Effect of Long-Term Angiotensin-Converting Enzyme Inhibitor Therapy on Arterial Oxygen Saturation in Patients With Mild to Moderate Heart Failure |
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| Authors: | Dr Eric J Stanek PharmD Dr Andrew R Nara MD PhD Dr Kingman P Strohl MD Dr Ravi N Nair MD Mr Michael J Decker CRTT Dr Mark A Munger PharmD |
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| Institution: | 1. Division of Cardiology, Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio;2. Division of Pulmonary/Critical Care Medicine, Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio;3. Department of Pharmacy Practice, University of Utah College of Pharmacy, Salt Lake City, Utah |
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| Abstract: | Study Objective . To evaluate the effects of angiotensin-converting enzyme (ACE) inhibition on continuous pulse oximetry recordings of arterial oxygen saturation (SpO2). Design . Open-label study. Setting . Cardiology clinics at two large teaching hospitals. Patients . Eight patients with New York Heart Association Functional Class (NYHA FC) II-III heart failure. Interventions . Patients were studied after an ACE inhibitor washout (baseline, B), and after 3 months following resumption of therapy (ACEI). Measurements and Main Results . Monitoring times for B and ACEI were approximately 22 hours. Reduction trends were observed for number (190 ± 170 vs 125 ± 67 B vs ACEI), magnitude (8.2 ± 1.4% vs 7.5 ± 1.8%), and duration (2.45 ± 2.8 vs 1.35 ± 0.8 min) of desaturations/monitoring period, and for nadir SpO2/desaturation (88.1 ± 1.5% vs 89.9 ± 3.3%). The B desaturation index (cumulative desaturation time/monitoring period time) × 100, a measure of hypoxic stress or burden] decreased from 19.4 ± 8.1% to 11.9 ± 8.1% at ACEI (p=0.024). Conclusion . Long-term ACE inhibitor therapy improves the profile of SpO2 values over time in patients with NYHA FC II-III heart failure. |
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