Aim. To compare clinical effectiveness of the long-term ambulatory therapy (bronchodilators; bronchodilators and fenspiride; bronchodilators, fenspiride and an ACE inhibitor perindopril) among patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP). Material and methods. In total, 132 patients with COPD and CCP were examined. All participants were divided into three groups, according to the administered therapy (see above), and underwent clinical examination, echocardiography (EchoCG), computed spirography, 6-minute walk test, and other procedures. The examination took place at baseline, as well as 12 and 24 months after the study started. Results. In COPD and CCP patients, long-term therapy with bronchodilators and fenspiride was associated with a significant decrease in bronchial obstruction syndrome severity, a substantial improvement ill lung function (LF) and physical capability, and some improvement in EchoCG parameters, but did not influence mortality and chronic heart failure (CHF) progression. Adding an ACE inhibitor perindopril to the combined therapy resulted in a significant clinical improvement, even among the patients with severe COPD and decompensated CCP. Conclusion. Long-term treatment with a combination of inhaled bronchodilators, fenspiride, and an ACE inhibitor perindopril was highly effective and safe in patients with COPD and CCP, regardless of the disease severity.
