Russian Heart Failure Journal 2005year Evaluating the efficacy of drug correction for hemodynamic changes in patients with chronic pulmonary heart


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2005/

Evaluating the efficacy of drug correction for hemodynamic
changes in patients with chronic pulmonary heart

Chesnikova A.I.

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Urgency. Issues of efficient and safe therapy for chronic pulmonary heart (CPH) and HF in patients with chronic obstructive lung disease (COLD) presently remain unsolved. Aim of study. Evaluating the effect of ACEI and calcium channel blockers (CCB) on parameters of pulmonary and cardiac hemodynamics in patients with COLD in relation to HF severity, and the treatment safety. Material and methods. One hundred twenty eight patients with COLD and CPH were assigned to groups and evaluated: Group 1, patients with COLD and compensated CHF; Groups 2–4, patients with COLD, CPH and I, IIA or IIB stage CHF. Patients of each group were randomized to 3 subgroups in relation to the treatment administered: basic therapy, addition of the ACEI fosinopril or the CCB amlodipin. Treatment lasted for 12 weeks. Efficacy and safety of therapy were evaluated by dynamics of clinical and laboratory data, echoCG parameters, and data on external respiratory function. Results. It was demonstrated that amlodipin administration was more appropriate for patients with compensated CHF, which allowed decreasing the hemodynamic load on the right ventricle (RV) and preventing the development of CHF. In HF of any severity, it is necessary to administer ACEI, specifically fosinopril, which provides not only release of RV afterload but also regress of RV pathological remodeling and slower CHF progression.

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