Advantages of quinapril therapy in patients with arterial hypertension and functional class III chronic heart failure with preserved left ventricular ejection fraction
Kanorskiĭ, S.G.; Tregubov, V.G.; Pokrovskiĭ, V.M.
Kardiologiia 52(4): 31-37
2012
ISSN/ISBN: 0022-9040 PMID: 22839514 Document Number: 657802
To determine advantages of therapy of functional class (FC) I-II chronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction in patients with hypertensive disease (HD) with metoprolol succinate or quinapril and to assess their effect on regulatory-adaptive status. Two hundred patients with I-II FC CHF and LVEF >50% at the background of stage I-II hypertensive disease participated in this study. They were randomized into 2 groups. Group I comprised 104 patients (mean age 52.8+1.9 years) who were prescribed metoprolol succinate 87.7+/-7.6 mg/day. Patients of group 2 (n=96, mean age 55.0+/-1.4 years) were prescribed quinapril 21.0+55 mg/day. Examination at baseline and after 6 months of therapy included 6 min walk test, treadmillometry with assessment of maximal oxygen consumptiion (VO2max), echocardiography, 24 hour blood pressure monitoring, measurement of N-terminal precursor of brain natriuretic peptide (NT-proBNP); test of cardio-respiratory synchronism was used for objective qualitative determination of the state of the ,renin-angiotensin system. Both drugs improved parameters of LV diastolic function, but only quinapril effectively changed LV structural geometric parameters and systolic function. Only treatment with quinapril was associated with improvement of RAS, elevation of tolerance to physical effort, and increased VO2max. Quinapril more substantially lowered level of NT-proBNP. Quinapril has an advantage over metoprolol succinate in therapy of patients with FC I-II CHF and preserved LF EF at the background of stage I-II HD.