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  • Title: [Blockers of angiotensin receptors: a novel approach to the treatment of secondary pulmonary hypertension].
    Author: Butorov IV, Verbitskiĭ ON, Butorov SI.
    Journal: Ter Arkh; 2004; 76(6):84-7. PubMed ID: 15332584.
    Abstract:
    AIM: To evaluate efficacy of losartan, a blocker of angiotensin receptors, in combined treatment of secondary pulmonary hypertension (SPH) in patients with chronic obstructive bronchitis (COB). MATERIAL AND METHODS: Losartan effects on hemodynamics, blood gases and clinical course of the disease were studied in 29 patients with COB and SPH (mean age 52 +/- 1.7 years). A control group consisted of 15 patients (mean age 51 +/- 1.5 years) treated with cardiac glycosides and diuretic drugs. M- and B-mode Doppler echocardiography registered hemodynamic parameters. 24-h monitoring of AP and ECG were made by standard methods. Blood gases and venous rheology were examined. RESULTS: Losartan administration in COB patients with SPH improved hemodynamics. Stroke index rose from 36.3 +/- 2.1 to 45.8 +/- 2.1 ml/m2 (by 26.2%, p < 0.01) in SPH functional class III, from 26.3 +/- 1.9 to 32.7 +/- 2.1 ml/m2 (by 24.3%, p < 0.01) in functional class IV Cardiac index rose by 22.2 and 21.1%, respectively. Pulmonary hemodynamics improved too: systolic pressure in pulmonary artery fell by 25.7% in functional class III, by 18.6% in functional class IV. Losartan normalized a 24-h AP profile, reduced the number of painless myocardial ischemia. CONCLUSION: Use of losartan in combined therapy of patients with COB and SPH improves clinical status of the patients, corrects basic cardiohemodynamic parameters, has a positive effect on AP profiles without negative impact on blood gas composition and rheology.
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