Effectiveness of prestarium in the treatment of chronic cor pulmonale

AIM: To study efficiency and safety of application of perindopril (prestarium) in patients with chronic cor pulmonale (CCP). MATERIAL AND METHODS: The trial included 26 patients with chronic obstructive pulmonary disease complicated with CCP and cardiac failure of NYHA class II-III. The study group of 16 patients received perindopril 2-4 mg/day for 3 months. 10 controls received routine therapy. All the patients were examined before the treatment and 3 months after it using physical examination, echocardiography, Doppler echocardiography, 24-h Holter ECG monitoring, assessment of potassium and creatinine in the serum, quality of life. RESULTS: The treatment decreased functional class of cardiac failure and mean pulmonary arterial pressure, lowered malignant arrhythmia frequency, improved quality of life and intracardiac hemodynamics, inhibited right ventricular remodelling. CONCLUSION: Perindopril is well tolerated and safe efficient medicine in patients with decompensated CCP.     

Use of lozartan in patients with chronic cor pulmonale

The purpose of the study was to determine the effect of the angiotensin receptor blocker lozartan on clinical manifestations, gas transport, and metabolism in blood cells in patients with chronic cor pulmonale (CCP). The subjects were 53 patients with chronic obstructive bronchitis (COB) and secondary functional claa III pulmonary hypertension. Use of lozartan in complex therapy of these patients led to increase of pyruvic acid content in erythrocytes and glucose-6-phosphatdehydrogenase activity, which suggests that lozartan stimulates redox processes in blood cells. This significantly improves metabolic provision of erythrocyte functioning, phagocytosis and immunogenesis, and leads to favorable clinical effect in patients with COB and CCP.     

Endothelial dysfunction mediators in patients with chronic cor pulmonale

Forty-nine sourses of Russian and foreign literature dedicated to the role of endothelial dysfunction in the development of pulmonary hypertension and chronic cor pulmonale were analyzed. Data on endothelium-dependent vasoactive mediators are presented in the article.     

Echocardiographic evidence on development of chronic cor pulmonale in asthmatics

Early detection of chronic cor pulmonale (CCP) is essential for diagnosis of the patient's condition, choice of adequate therapy, improvement of the prognosis. The study of parameters of pulmonary hemodynamics, right and left heart in 125 patients with bronchial asthma determined how CCP is formed in such patients.     

Prevalence and natural course of chronic high-altitude cor pulmonale

Short-term and prospective epidemiological surveys conducted in Highlanders of the Tien Shan and Pamirs (2800-4200 m above the sea level) have shown that the chronic high-altitude pulmonary heart (CHAPH) is a common type of pathology, with growing age of the examinees the frequency of CHAPH being considerably on a decrease. CHAPH is characterized by a progressive course and is frequently complicated by various types of cardiac arrhythmia. With a growing degree of marked right ventricular hypertrophy the number of lethal outcomes among Highlanders increases.