Положительное влияние периндоприла на сосуды микроциркуляторного русла у больных с хронической сердечной недостаточностью

Цель    Оценка влияния 12‑месячной терапии периндоприлом на структурно-функциональное состояние сосудов микроциркуляторного русла (МЦР) у пациентов с хронической сердечной недостаточностью с сохранной (СНсФВ) и промежуточной (СНпФВ) фракцией выброса левого желудочка.

Материал и методы  Обследованы 30 пациентов с СНсФВ и СНпФВ. Всем был назначен периндоприл в максимально переносимой дозе на срок 12 мес. Проводилась оценка структурно-функциональных изменений сосудов МЦР при помощи фотоплетизмографии и капилляроскопии до начала терапии периндоприлом и через 12 мес, т. е. после ее окончания.

Результаты   На фоне 12‑месячной терапии периндоприлом отмечалось улучшение функции эндотелия в виде прироста индекса окклюзии (ИО) и сдвига фаз (СФ). ИО увеличился с 1,45 [1,3; 1,6] до 1,8 [1,6; 2,2] (p=0,00004). СФ увеличился с 7,1 мс [4,8; 10,2] до 9,2 мс [6,7; 13,2]) (p=0,0003). Обнаружено уменьшение жесткости крупных сосудов мышечного типа. Индекс жесткости (aSI) уменьшился с 8,8 [6,6; 11,0] до 7,45 [6,5; 9,4] м / с (р=0,01). На фоне терапии произошло увеличение плотности капиллярной сети в покое (р=0,008), при пробах с венозной окклюзией (р=0,003) и реактивной гиперемией (р=0,0003).

Заключение     По результатам исследования выявлено улучшение функции эндотелия на фоне терапии периндоприлом в течение 12 мес у пациентов с СНсФВ и СНпФВ.

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