Haemodynamic and renal effects of intravenous enalaprilat during coronary artery bypass graft surgery in patients with ischaemic heart dysfunction

Renal dysfunction occurring after open heart surgery is multifactorial in origin but activation of the renin–angiotensin system may have a prominent role. Fourteen patients with ischaemic heart dysfunction scheduled for elective coronary artery bypass graft (CABG) surgery were allocated to a treatment group [enalaprilat for 2 days; ACEI (angiotensin-converting enzyme inhibitor) group, n =7] or a control group ( n =7). The cardiac index was significantly higher in ACEI-treated patients than in the controls before and after cardiopulmonary bypass (CPB) ( P P P 131 I]orthoiodohippuran clearance (Cl H ), was higher in the ACEI group than in the control group before CPB, as was endogenous creatinine clearance after CPB ( P H was significantly higher in the ACEI group than in the control group ( P P