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.