Vol. 2, Issue 3 (2013)
Evaluation of the Effectivness of the Angiotensin-Converting Enzyme Inhibitor Enalapril and the Angiotensin II Receptor Blocker Candesartan use in Patients with Chronic Pulmonary Heart Disease According to the Dynamics of Fibroblast Growth Factor and Pulmonary Artery Systolic Pressure
The aim of our research was to investigate the effects of prolonged use of the angiotensin-converting enzyme (ACE) inhibitor enalapril and the angiotensin II receptor blocker (ARB) candesartan on the blood levels of basic fibroblast growth factor (bFGF) and dynamics of pulmonary artery systolic pressure (PASP) in patients with chronic pulmonary heart disease (CPHD). The study involved 282 patients with compensated and decompensated CPHD with heart failure (HF) NYHA Class II-IV, including 214 (75.9%) men and 68 (24.1%) women. The average age of men – (59.2 ± 10.8) years, women – (63.7 ± 4.5) years. It was found that the most pronounced increase of bFGF level to (63.48 ± 8.65) pg / ml versus referential value of this index (18.61 ± 4.96) pg / ml (p < 0.001) was observed in patients with CPHD with HF NYHA Class IV. ACE inhibitor enalapril and the angiotensin II receptor blocker candesartan on the background of the basic therapy inhibit an excessive production of bFGF and progression of pulmonary arterial hypertension, which indicates the feasibility of adding them to the standard CPHD treatment. The angiotensin II receptor blocker candesartan should be added to the basic therapy in the early stages of CPHD development. A combined use of the basic therapy with ACE inhibitor enalapril and the angioten II receptor blocker candesartan is appropriate during the later stages of CPHD NYHA Class III-IV.