ABSTRACT
The aim of the study was to evaluate effects of losartan receptor I antagonist (AT) and/or angiotensin converting enzyme inhibitor (iACE) on clinical manifestations of the disease, hemodynamic characteristics, morphofunctional heart parameters in patients with chronic cardiac insufficiency (CHI) complicating coronary heart disease (CHD). A total of 60 patients aged 48-72 (mean 62 +/- 8.4) years with persistent symptoms of functional class II-IV CHI and left ventricular (LV) fraction = < 45% complicating CHD. They were divided into 3 groups of 20 patients each. Patients in group 1 were given losartan (50 mg daily), in group 2 lisinopril (10 mg daily), in group 3 combination of the two drugs for 24 weeks. Combined treatment produced more significant improvement of CHI symptoms than monotherapy with either drug. In all cases, the size of heart left chambers decreased while contractility of left ventricular myocardium increased but these effects were more pronounced after combined therapy.
Subject(s)
Heart Failure/drug therapy , Hemodynamics/drug effects , Lisinopril/therapeutic use , Losartan/therapeutic use , Ventricular Function/drug effects , Aged , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Cardiotonic Agents/therapeutic use , Drug Therapy, Combination , Echocardiography , Exercise Test , Female , Follow-Up Studies , Heart Failure/diagnosis , Heart Failure/physiopathology , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
AIM: To study effects of long-term administration of fenspiride in combination with broncholytic drugs on dynamics of clinical symptoms, external respiration function and quality of life in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: A comparative randomized trial of fenspiride used for 6 months in combination with broncholytic drugs enrolled 68 COPD patients. A clinical status, external respiration function were examined. Quality of life was evaluated with WHO questionnaire WHOQOL-100. RESULTS: Addition of fenspiride to combined treatment of COPD attenuates COPD symptoms, normalizes blood biochemistry, improves external respiration function, raises exercise tolerance. Quality of life improved by physical and mental state scales. CONCLUSION: Fenspiride addition to COPD treatment improves efficacy of the standard treatment and is recommended for treatment of COPD of stage I and II in combination with broncholytic drugs.
Subject(s)
Ambulatory Care/methods , Bronchodilator Agents/therapeutic use , Exercise Tolerance/physiology , Pulmonary Disease, Chronic Obstructive/psychology , Quality of Life , Spiro Compounds/therapeutic use , Vital Capacity/physiology , Adult , Anti-Asthmatic Agents , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/physiopathology , Surveys and Questionnaires , Treatment OutcomeABSTRACT
AIM: To study effects of long-term administration of ACE inhibitor ramipril (hartil) on renin-angiotensin-aldosteron system (RAAS), dynamics of clinical symptoms of the disease and structural-functional indices of the right and left ventricle (RV, LI) in patients with chronic obstructive pulmonary disease (COPD) with decompensated chronic cor pulmonale (CCP). MATERIAL AND METHODS: X-ray examination, echocardiography (echo-CG), investigation of external respiration function were made in 45 patients with non-exacerbated COPD with CCP. The study group consisted of 25 COPD patients with CCP. They received ramipril (hartil) in a dose 2.5-5 mg. The control group of 20 patients did not receive ACE inhibitors. RESULTS: As shown by echo-CG, administration of hartil in decompensated CCP significantly improved diastolic LV and RV functions, reduced systolic and diastolic sizes of both ventricles and atria. To treatment month 12 the changes enhanced with improvement of the systolic function. Patients with decompensated CCP who had no long-term correction of RAAS exhibited deterioration of RV systolic and diastolic function, the size of their right atrium and ventricle enlarged, blood pressure in the pulmonary artery rose. CONCLUSION: Long-term administration of ACE inhibitor hartil in COPD patients with CCP in personally adjusted doses in outpatient conditions is effective and results in positive structural-functional changes of the right heart.
