Angiotensin converting enzyme inhibitors and pulmonary hypertension.

ANGIOTENSIN CONVERTING ENZYME INHIBITORS AND PULMONARY HYPER- TENSION (Abstract): Aim: To evaluate the efficacy of angiotensin converting enzyme in- hibitors Enalapril, Fosonopril and Moexipril on mean and systolic pulmonary artery pre s- sure. Material and methods: The study included 111 patients with chronic obstructive bronchopneumopathies associated with arterial hypertension and mild to moderate he art fail- ure (NYHA I-II class). The patients were examined at baseline and after 60 days of treat- ment. The central hemodynamic parameters and mean and systolic pulmonary artery pre s- sure 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 ve- locities, right ventricular/pulmonary artery systolic pressure (RV/ PASP). The mean pulm o- nary 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. Keywords: ANGIOTENSIN CONVERTING ENZYME INHIBITORS, CHRONIC OBSTRUCTIVE BRONCHOPNEUMOPATHY, PULMONARY HYPERTENSION, HEART FAILURE.