Safonova J I, Kozhevnikova M V, Danilogorskaya Yu A, Zheleznykh E A, Zektser V Y, Shchendrygina A A, Ilgisonis I S, P E V, Khabarova N V, Belenkov Yu N
Sechenov First Moscow State Medical University (Sechenov University), Moscow.
Kardiologiia. 2020 Sep 17;60(8):65-70. doi: 10.18087/cardio.2020.8.n1216.
Aim To evaluate the effect of 12-month perindopril treatment on structure and function of microvasculature (MV) in patients with chronic heart failure with preserved (HFpEF) and intermediate (HFiEF) left ventricular ejection fraction.Material and methods 30 patients with HFpEF and HFiEF were evaluated. Perindopril at a maximum tolerated dose was administered to all patients for 12 months. Changes in MV structure and function were assessed with photoplethysmography and capillaroscopy prior to the treatment onset and at 12 months, i.e., after completion of the perindopril treatment.Results The 12-month perindopril treatment was associated with improvement of the endothelial function evident as increases in the occlusion index (OI) and the phase shift (PS). OI increased from 1.45 [1.3; 1.6] to 1.8 [1.6; 2.2] (p=0.00004). PS increased from 7.1 ms [4.8; 10.2] to 9.2 ms [6.7; 13.2] (p=0.0003). Stiffness of muscular large blood vessels was decreased. Arterial stiffness index (aSI) decreased from 8.8 [6.6; 11.0] to 7.45 [6.5; 9.4] m /s (р=0.01). The perindopril treatment was associated with increased density of the capillary network at rest (р=0.008) and in tests with venous occlusion (р=0.003) and reactive hyperemia (р=0.0003).Conclusion The study showed an improvement of endothelial function associated with the 12-month perindopril therapy in patients with HFpEF and HFiEF.
目的 评估培哚普利12个月治疗对左心室射血分数保留的慢性心力衰竭（HFpEF）和中度左心室射血分数（HFiEF）患者微血管（MV）结构和功能的影响。
材料与方法 对30例HFpEF和HFiEF患者进行评估。所有患者均接受最大耐受剂量的培哚普利治疗12个月。在治疗开始前和12个月时，即培哚普利治疗结束后，用光电容积描记法和毛细血管镜评估MV结构和功能的变化。
结果 培哚普利12个月治疗与内皮功能改善相关，表现为闭塞指数（OI）和相移（PS）增加。OI从1.45[1.3；1.6]增加到1.8[1.6；2.2]（p=0.00004）。PS从7.1毫秒[4.8；10.2]增加到9.2毫秒[6.7；13.2]（p=0.0003）。肌肉性大血管的僵硬度降低。动脉僵硬度指数（aSI）从8.8[6.6；11.0]降至7.45[6.5；9.4]米/秒（р=0.01）。培哚普利治疗与静息时（р=0.008）、静脉闭塞试验时（р=0.003）和反应性充血时（р=0.0003）毛细血管网络密度增加相关。
结论 该研究表明，培哚普利12个月治疗可改善HFpEF和HFiEF患者的内皮功能。
