REGULATORY ADAPTIVE STATUS IN DETERMING THE EFFECTIVENESS OF ZOFENOPRIL AND LISINOPRIL IN PATIENTS WITH CHRONIC HEART FAILURE WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION

Abstract

Goal. Сompare the effectiveness of combination therapy with zofenopril and lisinopril in patients with preserved ejection fraction (CHFpEF) of the left ventricle (LV) in the presence of hypertension disease (HD), considering its impact on the regulatory adaptive status (RAS). Material and methods. 69 patients with CHFpEF in the presence of HD III stage who were randomized into two groups for treatment with zofenopril (17,9±5,9 mg/day, n=35) or lisinopril (14,2±4,3 mg/day, n=34). As part of combination pharmacotherapy, patients were included nebivolol (6,5±1,8 mg/day and 5,8±1,7 mg/day), and acetylsalicylic acid when required (100 mg/day, n=7 and 100 mg/day, n=8), atorvastatin (16,5±4,7 mg/day, n=12 and 15,7±4,8 mg/day, n=14), respectively. Initially and after six months, the following was done: a quantitative evaluation of the RAS (by cardio-respiratory synchronism test), echocardiography, treadmill test, six-minute walking test, determination of the N-terminal precursor of the natriuretic brain peptide level in blood plasma, holter monitoring of blood electrocardiograms, all-day monitoring of pressure, subjective evaluation of quality of life. Results. Both schemes of combined therapy comparatively controlled arterial hypertension, improved functional and structural state of the heart, reduced neurohumoral activity. Compared with lisinopril, the use of zofenopril more positively influenced on RAS, increased exercise tolerance and improved quality of life. Conclusion. The use of zofenopril, in comparison with lisinopril, in patients with CHFpEF LV on the background HD of III stage is preferable due to a more positive effect on RAS.