EFFECT OF ACE INHIBITOR AND RECEPTOR ANTAGONIST OF TYPE 1 ANGIOTENSIN II ON HEMODYNAMICS AND MORPHO-FUNCTIONAL PARAMETERS OF THE HEART IN PATIENTS WITH HEART FAILURE ON A BACKGROUND OF CORONARY HEART DISEASE COMBINED WITH TYPE 2 DIABETES
https://doi.org/10.25207/1608-6228-2017-24-3-11-16
Abstract
Aim. The article discusses the evaluation of the effect of 3-month therapy of angiotensin-converting enzyme fosinopril and angiotensin II receptor antagonists valsartan on the clinical manifestations of CHF, hemodynamics and morphofunctional parameters of the heart, taking into account the function of the right ventricle and systolic pressure in the pulmonary artery in patients with ischemic heart disease Postinfarction cardiosclerosis in combination with type 2 diabetes.
Material and Methods. 69 patients with IHD PICS, complicated by CHF II-III FC in combination with type 2 diabetes, were under observation. Patients were randomized into 2 groups: the first group consisted of 35 people taking fosinopril with an average daily dose of 20 mg, the second group consisted of 34 people taking ARS II valsartan at an average daily dose of 80 mg. Initially and after 12 weeks of treatment, all patients underwent a clinical examination, including clinical assessment of CHF manifestations, office blood pressure measurement and ECHR.
Results. The appointment of ACEI and ARA II, led to an improvement in the clinical state of patients and the expansion of the functional capabilities of the myocardium.
Conclusion. It should be noted that, without any particular advantages, in the effect on heart remodeling processes, fosinopril administration had a more pronounced effect on the systolic function of the left ventricle, and the use of valsartan significantly improved the diastolic function of the left ventricle.
About the Authors
Z. V. BITAROVARussian Federation
Department of Internal Medicine №4
Russia, 362007, Republic of North Ossetia – Alania Vladikavkaz, str. Pushkinskaya, 40; tel.: 8-989-741-03-91
O. V. REMIZOV
Russian Federation
Department of Internal Medicine №4
Russia, 362007, Republic of North Ossetia – Alania Vladikavkaz, str. Pushkinskaya, 40; tel.: 8-989-741-03-91
Z. T. ASTAKHOVА
Russian Federation
Department of Internal Medicine №4
Russia, 362007, Republic of North Ossetia – Alania Vladikavkaz, str. Pushkinskaya, 40; tel.: 8-989-741-03-91
References
1. Mareev V.Ju., Danieljan M.O., Belenkov Ju.N. Sravnitel'naja harakteristika bol'nyh s HSN v zavisimosti ot velichiny frakcii vybrosa po rezul'tatam rossijskogo mnogocentrovogo issledovanija JePOHA-O-HSN: snova o probleme HSN s sohrannoj sistolicheskoj funkciej levogo zheludochka. Serdechnaja nedostatochnost'. 2006; 4: 164–171. (In Russ.)
2. Lam C.S., Donal E., Kraigher-Krainer E., Vasan R.S. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011; 13: 18–28.
3. Lloyd-Jones D., Adams R.J., Brown T.M. et al. Heart disease and stroke statistics – 2010 update: a report from the American Heart Association. Circulation. 2010; 121: e46-e215.
4. Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J. 2012; 33: 1750- 1757.
5. Roger V.L., Mozaffarian D. Heart disease and stroke statistics – 2013 update: a report from the merican Heart Association. Circulation. 2013; 127: e6–e245.
6. Wong C.M., Hawkins N.M., Jhund P.S., et al. Clinical characteristics and outcomes of young and very oung adults with heart failure: The CHARM programme (Candesartan in Heart Failure Assessment of eduction in Mortality and Morbidity). JACC 2013; 62: 1845-1854.
7. Fomin I.V. Jepidemiologija hronicheskoj serdechnoj nedostatochnosti v Rossijskoj Federacii. In Ageev F.T. Hronicheskaja serdechnaja nedostatochnost'. M.: GJeOTAR- Media, 2010; 7–77. (In Russ.)
8. Mareev V.Ju., Belenkov Ju.N. Hronicheskaja serdechnaja nedostatochnost' i insulinnezavisimyj saharnyj diabet: sluchajnaja svjaz' ili zakonomernost'? Ter. Arhiv. 2003; 75 (10): 5–10. 145. (In Russ.)
9. Timmis A.D. Diabetic heart disease: clinical considerations. Heart. 2001; 85 (4): 463-469.
10. Krumholz H.M., Chen Y.T., Wang Y. et al. Predictors of readmission among elderly survivors of admission with heart failure. Am Heart J. 2000; 139 (1 Pt 1): 72–77.
11. Belenkov Ju. N. Remodelirovanie levogo zheludochka: kompleksnyj podhod. Serdechnaja nedostatochnost. 2002; 3(4): 161-163. (In Russ.)
12. Belenkov Ju.N., Mareev V.Ju., Ageev F.T. Medikamentoznye puti uluchshenija prognoza bol'nyh s hronicheskoj serdechnoj nedostatochnost'ju. M.: Insajt, 1997; 77. (In Russ.)
13. Garg R., Yusuf S., for the Collaborative Group on ACE Inhibitor Trials. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. JAMA. 1995; 273(18): 1450–1456.
14. Jorde U.P.,Ennezat P.V., Lisker J., et al. Maximalle recommended doses of angiotensin-converting enzyme ingibitors do not completely prevent ACE-mediaeted formation of angiotensin II in chronic heart failure. Circulation. 2000; 1.
15. Patel A.; ADVANCE Collaborative Group. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007; 370(9590): 829–840.
16. Bogdanov D.V. Remodelirovanie pravogo zheludochka pri gipertroficheskoj neobstruktivnoj kardiomiopatii. Serdechnaja nedostatochnost'. 2009; 10(5): 263-265. (In Russ.)
Review
For citations:
BITAROVA Z.V., REMIZOV O.V., ASTAKHOVА Z.T. EFFECT OF ACE INHIBITOR AND RECEPTOR ANTAGONIST OF TYPE 1 ANGIOTENSIN II ON HEMODYNAMICS AND MORPHO-FUNCTIONAL PARAMETERS OF THE HEART IN PATIENTS WITH HEART FAILURE ON A BACKGROUND OF CORONARY HEART DISEASE COMBINED WITH TYPE 2 DIABETES. Kuban Scientific Medical Bulletin. 2017;(3):11-16. (In Russ.) https://doi.org/10.25207/1608-6228-2017-24-3-11-16