[Renin-angiotensin-aldosterone system and pulmonary hemodynamics in patients with pulmonary artery hypertension].

To investigate the relationship between renin-angiotensin-aldosterone system and pulmonary hemodynamic parameters in patients with chronic pulmonary artery hypertension, we measured plasma levels of renin activity, angiotensin II and aldosterone in 11 patients during right heart catheterization. All patients had chronic obstructive pulmonary disease. At rest, plasma concentration of angiotensin II positively correlated with mean pulmonary artery pressure (r = 0.76, P less than 0.01) and pulmonary vascular resistance (r = 0.64, P less than 0.05). During exercise, plasma level of angiotensin II increased from 70 +/- 21 to 81 +/- 24 pg/ml (P less than 0.01) and plasma renin activity from 0.66 +/- 0.54 to 1.28 +/- 1.2 ng/ml/h (P less than 0.05), whereas mean pulmonary artery pressure increased from 3.73 +/- 0.85 to 6.27 +/- 1.81 kPa (28 +/- 6.4 to 47 +/- 13.6 mmHg). Increase of angiotensin II correlated with changes in mean pulmonary artery pressure (r = 0.69, P less than 0.05) but not with systemic artery pressure. The results of present study suggest that angiotensin II might play a role in the development of pulmonary artery hypertension in patients with chronic obstructive pulmonary disease.