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[Effect of 12-Months Therapy With Perindopril A on Structural-Functional State of the Microcirculatory Vascular Bed
Yu N Belenkov1, E V Privalova1, Yu A Danilogorodskaya1
1Sechenovs First Moscow State Medical University, Moscow, Russia.
Insights
Perindopril A treatment improved microvascular endothelial function and capillary network in chronic heart failure patients. This was linked to a significant reduction in the pro-inflammatory cytokine tumor necrosis factor.
Area of Science:
- Cardiology
- Vascular Biology
- Pharmacology
Background:
- Endothelial dysfunction (ED) in microvessels is a key factor in chronic heart failure (CHF) progression.
- Understanding mechanisms of ED is crucial for developing effective CHF treatments.
Purpose of the Study:
- To evaluate the 12-month impact of perindopril A on the microcirculatory vascular bed in CHF patients.
- To assess perindopril A's effects on endothelial function and microvascular structure.
Main Methods:
- A study involving 30 patients (45-70 years) with NYHA class II-III CHF receiving perindopril A (5-10 mg/day) for 12 months.
- Endothelial function assessed via reactive hyperemia test using photoplethysmography.
- Microcirculation evaluated using computer videocapillaroscopy; proinflammatory cytokines (von Willebrand factor, TNF) measured.
Main Results:
- Perindopril A treatment significantly improved microvascular endothelial function (occlusion index increased, p=0.03).
- Functional state of the finger skin capillary network improved (perfused and recovered capillaries increased, p=0.05 and p=0.04, respectively).
- A significant reduction in tumor necrosis factor (TNF) levels was observed (p<0.01).
Conclusions:
- Perindopril A demonstrates beneficial effects on microvascular endothelial function and structure in CHF patients.
- The drug may mitigate CHF progression by reducing inflammation, specifically lowering TNF levels.
Background:
Experimental and clinical data confirm that endothelial dysfunction (ED) of microvessels is one of mechanisms of progression of chronic heart failure (CHF).
Purpose:
To assess the impact of 12-month treatment with perindopril A (5-10 mg/day) on structural and functional state of microcirculatory vascular bed in patients with CHF.
Material And Methods:
We included into this study 30 patients aged 45-70 years with NYHA class II-III CHF. All patients received perindopril A 5-10 mg/day for 12 months. For assessment of endothelial function we used test with reactive hyperemia. During this test we evaluated flow dependent vasodilation by photoplethysmography, and registered the state of skin capillary network by computer videocapillaroscopy. We also measured level of proinflammatory cytokines - von Willebrand factor, and -tumor necrosis factor (-TNF).
Results:
After treatment with perindopril A 5 we observed improvement of microvascular endothelial function (occlusion index rose from 1.5 [1.2; 2.9] to 2.0 [1.7; 2.4], p=0.03), and of functional state of the finger skin capillary network (percentage of perfused capillaries rose from 88 [77; 95] to 95 [87; 97], p=0.05, percentage of recovered capillaries rose from 8 [4.5; 12.1] to 14.2 [9.3; 17.1], p=0.04). These effects were associated with significant lowering of (-TNF) level (from 6.58 [3.72, 10.3] to 3.35 [0.15; 6.33] g/L, p<0.01).
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