TELMISARTAN EFFECTIVENESS IN THE TREATMENT OF PATIENTS WITH CHRONIC COR PULMONALE

The aim of the research is to study the effectiveness of the influence of telmisartan angiotensin II receptor antagonist on the state of pulmonary-heart and cerebral hemodynamics in patients with chronic obstructive pulmonary disease (COPD), complicated with chronic cor pulmonale (CCP). Telmisartan (Мicardis^®, Boehringer Ingelheim, Germany) in the doze of 40 mg/day was added into the complex therapy of 30 patients with COPD at different stages of CCP formation for the correction of pulmonary-heart and cerebral hemodynamics. After 6-month prospective study it was found out that the use of telmisartan in the treatment of COPD patients leads to the decrease of pressure in the pulmonary artery, lowering of volume parameters of the right ventricle and the increase of the ejection fraction of the right ventricle. In the first group the most obvious effect was observed in 6 months of treatment. The patients of this group were registered to have the normalization of systolic pressure in the pulmonary artery in comparison with the initial values, the decrease of end-diastolic (p=0.001) and end-systolic (p=0.001) volumes of the right ventricle, the increase of the ejection fraction of the right ventricle (p=0.02). The patients of the second group due to the treatment with telmisartan had pulmonary-heart hemodynamics parameters improvement characterized by the drop of systolic pressure in the pulmonary artery (p=0.05), the decrease of end-diastolic ((p=0.02) and end-systolic (p=0.02) volumes of the right ventricle, the increase of the ejection fraction of the right ventricle in comparison with the initial values. At the same time the patients of this group did not have the normalization of these parameters by the 6^th month of telmisartan therapy. The positive influence on the state of main head arteries in COPD patients was concomitant with the decrease of vascular remodeling processes, the increase of the linear blood flow velocity at extra- and intracranial levels. A more obvious clinical effect was achieved at the use of temisartan in the complex therapy of COPD patients at the stage of compensated CCP.

хроническая обструктивная болезнь легких, хроническое легочное сердце, легочно-сердечная и церебральная гемодинамика, сосудистое ремоделирование магистральных артерий головы, телмисартан, chronic obstructive pulmonary disease, chronic cor pulmonale, pulmonary-heart and cerebral hemodynamics, vascular remodeling of main head arteries, telmisartan

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