DOI: https://doi.org/10.22141/2224-0586.5.52.2013.88892

Effectiveness of Renin-Angiotensin System Blockers in Patients with Coronary Heart Disease after Surgery Coronary Artery Bypass Grafting

M.N. Dolzhenko, Yu.A. Luchinskaya, S.V. Potashev, A.Yu. Kruglova

Abstract


Objective. To evaluate the impact of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the recovery of myocardial function in patients with ishcemic heart disease after coronary artery bypass surgery within 1 year of follow-up.
Methods. A comprehensive survey and dynamic observation of 140 patients were conducted. Besides general clinical observation, all patients underwent Doppler echocardiography 7–10 days prior to and after surgery, in 6 months of 1 year of follow-up.
Results. According to Doppler echocardiography, the effects of angiotensin-converting enzyme inhibitors are being fixed already within 6 months after surgical revascularisation, but they are moderate. Reduction of the size of left atrium and pressure in it under a slight reverse remodeling of the left ventricle, with a tendency to a nonsignificant increase of its cavity, unchanged left ventricular ejection fraction and central hemodynamics parameters. Administration of angiotensin II receptor blockers enables to fix a significant improvement in most indicators of myocardial function of the left ventricle, the remodeling of the left chambers and central hemodynamics in just 12 months after revascularisation, but these positive changes are persistent and significantly higher than those in patients receiving angiotensin-converting enzyme inhibitors with a moderate reduction in left ventricular systolic function.


Keywords


myocardial function; coronary artery bypass grafting; coronary heart disease

References


Drenger B., Fontes M.L. Patterns of Use of Perioperative Angiotensin-Converting Enzyme Inhibitors in Coronary Artery Bypass Graft Surgery With Cardiopulmonary Bypass // Circulation. — 2012. — 126. — 261-269.

Paul M., Poyan Mehr A., Kreutz R. Physiology of local renin-angiotensin systems // Physiol. Rev. — 2006. — 86. — 747-803.

Doerschug K.C., Delsing A.S., Schmidt G.A., Ashare A. Renin-angiotensin system activation correlates with microvascular dysfunction in a prospective cohort study of clinical sepsis // Crit. Care. — 2010. — 14. — R24.

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery // J. Am. Coll. Cardiology. — 11.07.2011.

2010 ACCF/AHA Guidelines on myocardial revascularization // European Heart Journal. — 2010. — 31. — 2501-2555.

EAE/ASE Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography // European Journal of Echocardiography. — 2009. — 10. — 165-193.

Dolzhenko M.N., Rudenko S.A., Potashev S.V., Simagina T.V. Left ventricle diastolic function in the patients after coronary arteries bypass graft combined with left ventricle aneurismectomy according to tissue doppler imaging: one year follow-up // PMJ. — 2007. — Vol. 83, № 979. — P. 320-324.

Носенко Н.Н., Поташев С.В., Симагина Т.В., Перепельченко Н.А. Тканевая миокардиальная допплер-эхокардиография: возможности и ограничения метода // Внутренняя медицина. — 2007. — № 6(6).

Рекомендації робочої групи з функціональної діагностики Асоціації кардіологів України та Всесвітньої асоціації фахівців з ехокардіографії. Кількісна оцінка ехокардіографічних показників порожнин серця // Аритмологія. — 2012. — № 4(4). — С. 44-65.




Copyright (c) 2017 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта