Kapustnik V. A., Brek V. V., Telegina N. D., Pogorelov
V. N., Shelest B. A., Al-Halboos. M. A.
Kharkiv National
medical University, Kharkiv, Ukraine
Efficacy of left ventricle dysfunction treatment with losartan and
enalapril in patients with coronary artery disease
Background. The left
ventricle dysfunction is a threatening condition which often develops in
patients with coronary artery disease (also known as ischemic heart disease)
leading to a high risk of vitally significant heart failure [1, c. 1; 2, c. 902;
3, c. 562].
The aim of the research was to
evaluate efficacy of left ventricle dysfunction treatment with losartan and
enalapril in patients with coronary artery disease.
Materials and methods. In 21 patients with
coronary artery disease (CAD) and left ventricle
dysfunction of 2nd–3rd
functional class (FC) according to
criteria of New York Heart Association and ventricular extrasystoles (VE) an efficacy of enalapril and losartan was studied in terms of their action
on functional condition of myocardium and coronary circulation using impulse
echocardiography, static load tests, rheography and
24-hours monitoring of electrocardiography.
Results and discussion. After 12-weeks treatment
with enalapril in dosage of 2.5–20 mg a day and losartan in dosage of 50 mg a day a moderate increase of ejection fraction
from 41.4±1.8 % to 50.9±2.2 % (Ð<0.05) was registered in
patients with 2nd FC and from 35.6±1.9 % to 46.5±1.7 % in patients with 3rd
FC. A decrease of an
end-systolic size by 14 % in patients with 2nd
FC and 19 % – in patients with 3rd FC has
been noticed. Statistically
significantly a decrease of arterial blood pressure in patients with 2nd
and 3rd occurred. In patients with 2nd FC the level of systolic arterial blood
pressure (BPs) has been 158.4±6.3 mm Hg and 123.7±4.9 mm Hg (Ð<0,05). In patients with 3rd
FC the BPs became
decreased from 156.3±9.8 mm Hg to 129.6±6.9 mm Hg (Ð<0,05). The diastolic
arterial blood pressure has been decreased from 93.8±3.4 mm Hg to 79.6±2.2 mm Hg. Simultaneously, a
decrease of general peripheral
vascular resistance (GPVR) occurred. In patients with 2nd FC – from 1792.3±135.4 dyn. s. cm-5 to 1228.8±119.6 dyn. s. cm-5; in patients with 3rd
FC the GPVR became decreased from 1898.7±141.9 dyn. s. cm-5 to 1392.4±129.1 dyn. s. cm-5 (Ð<0,05). By Holter monitoring it was registered that the frequency of VE has decreased by 23 %. According to
results of static load tests the
degree of S-T interval depression has diminished after the treatment by 19.8 %.
Conclusion. Thus, the combined treatment of patients having left ventricle dysfunction with enalapril and
losartan is accompanied by improvement of not only contractile function of
myocardium and coronary
circulation, but also by
decrease of ventricle extrasystoles
frequency.
Literature
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