Russian Heart Failure Journal 2006year Correction of endothelial dysfunction in patients with chronic pulmonary heart using angiotensin-converting enzyme inhibitors


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2006/

Correction of endothelial dysfunction in patients with chronic pulmonary heart using angiotensin-converting enzyme inhibitors

Zadionchenko V.S., Nesterenko O.I., Pogonchenkova I.V., Shchikota A.M., Kholodkova N.B., Malyshev I.Yu., Manukhina E.B., Kruglov S.V., Pokidyshev D.A., Zemnina O.A.

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Urgency. Great significance has been recently attached to the role of pulmonary artery endothelium in regulation of pulmonary circulation, development of pulmonary hypertension and HF in patients with chronic obstructive lung disease (COLD). This explains the necessity and importance of studies focused on endothelial function and drug correction of endothelial dysfunction in such patients. Aim. To study features of endothelial dysfunction, synthesis of protective stress proteins, microcirculation, hemorheology and platelet vascular hemostasis in relation to the cardiopulmonary function, and to evaluate efficacy of the ACEIs perindopril and quinapril in such patients. Material and methods. Features of endothelial dysfunction and synthesis of the cytoprotective proteins HSP70 were studied in relation to the cardiovascular function in 100 patients with COLD complicated with CPH. Efficacy of the ACEIs perindopril and quinapril was evaluated for 6 months vs. standard therapy. Results. As CPH progressed the degree of endothelial dysfunction and depression of cytoprotective protein HSP70 synthesis significantly increased. It was shown that addition of ACEI to the multimodal treatment of COLD complicated with CPH improved endothelial function, beneficially influenced the clinical course of disease, parameters of central hemodynamics (particularly in patients with decompensated COLD) and did not compromise the external respiration function(ERF). It was the first demonstration of a new possible mechanism for the protective effect of accupro, recovery of the HSP70 protective system in patients with CPH.

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