ANGIOTENSIN CONVERTING ENZYME INHIBITORS AND PULMONARY HYPERTENSION

Aim: To evaluate the efficacy of angiotensin converting enzyme inhibitors Enalapril, Fosonopril and Moexipril on mean and systolic pulmonary artery pressure. Material and methods: The study included 111 patients with chronic obstructive bronchopneumopathies associated with arterial hypertension and mild to moderate heart failure (NYHA I-II class). The patients were examined at baseline and after 60 days of treatment. The central hemodynamic parameters and mean and systolic pulmonary artery pressure were studied by Doppler echocardiography (Phillips HD11XE). The pulmonary artery was viewed by left parasternal approach - cross section of the aorta. The following were measured: pulmonary artery flow acceleration and deceleration time (pafAT/pafDT), right ventricular izovolumetric relaxation time (IVRT), mean and peak pulmonary blood flow velocities, right ventricular/pulmonary artery systolic pressure (RV/PASP). The mean pulmonary artery pressure (MPAP) was estimated based on pulmonary flow acceleration time and right ventricular ejection time. Results: Following the treatment with angiotensin converting enzyme inhibitors a positive dynamics of SF pattern close to the normal one - a domelike contour with the maximum almost in the middle of diastole was noticed. Conclusions: the quantitative estimation revealed the considerable reduction in pulmonary artery systolic pressure (PASP) (from 46.3 +/- 3.3 mmHg at baseline to 32.1 +/- 2.6 mmHg after treatment, p < 0.01) and MPAP - from 26.7 +/- 3.2 mmHg at baseline to 23.2 +/- 2.6 mmHg after treatment, p < 0.01.