Endothelial dysfunction and its correction with perindopril therapy in patients with coronary heart disease

Abstract

Aim. To investigate endothelial dysfunction (ED) in patients with coronary heart disease (CHD), stable effort angina, Functional Class (FC) I-III, as well as to study perindopril potential in ED correction.Material and methods. The study included 37 CHD patients (22 men, 15 women; mean age 62,2+5,3 years) with FC I-II (n=22) and FC III angina (n=15). The control group included 16 healthy individuals. Fndothelium-dependent vasodilatation (FDVD) of brachial artery (BA) was assessed in reactive hyperemia test at baseline and after 6 weeks of perindopril therapy (8 mg/d); in controls, FDVD was assessed at baseline only.Results. At baseline, ED was observed in 79 % of CHD patients: in 42 %, as an inadequate vasodilatation effect (< 10 % from the baseline), and in other 37 %, as no BA diameter increase or vasoconstriction. ED was more prevalent in individuals with FC III angina (93 %) than in participants with FC I-II angina (69 %). Perindopril therapy was associated with increased numbers of patients with vasodilatation > 10 % (+9 %)or<10 % (+3,5 %), while the number of participants with vasoconstriction reduced by 12,5 %. The number of ED participants reduced by 26 % and 8 % for FC I-II and FC III, respectively. Among those with FC I-II angina, perindopril treatment was associated with significant increase in BA diameter (+9,8 %; p<0,05), linear and volumic blood flow velocity (from 15,0+1,9 to 41,5+2,1 cm/s (p<0,05) and from 2,1+0,5 to 6,9+0,5 ml/s (p<0,05), respectively).Conclusion. Adding perindopril (8 mg/d) to standard anti-ischemic therapy was associated with reduced ED, which could be regarded as a vasoprotective perindopril effect.

Keywords

• coronary heart disease
• endothelial dysfunction
• perindopril