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


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.


myocardial function; coronary artery bypass grafting; coronary heart disease


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