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首页> 外文期刊>Journal of cardiac failure >Reversal of peripheral microvascular dysfunction during long-term treatment with the angiotensin-converting enzyme inhibitor fosinopril in congestive heart failure.
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Reversal of peripheral microvascular dysfunction during long-term treatment with the angiotensin-converting enzyme inhibitor fosinopril in congestive heart failure.

机译：在充血性心力衰竭中长期使用血管紧张素转换酶抑制剂福辛普利逆转外周微血管功能障碍。

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BACKGROUND: Treatment with angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure (CHF) improves cardiac and peripheral hemodynamic function and exercise performance. However, studies on the effects of long-term treatment with an ACE inhibitor on the neurogenic and nonneurogenic regulation and structural microangiopathy of the peripheral microvasculature in CHF are lacking. METHODS AND RESULTS: We investigated the effect of 12 weeks of treatment with the ACE inhibitor fosinopril on peripheral microvascular function in a double-blind, placebo-controlled study of 12 patients treated with fosinopril and 10 patients treated with placebo. All had moderate CHF. Microvascular blood flow and resistance were calculated after application of the local isotope washout method in relaxed and nonrelaxed calf vascular beds in the supine position and during head-up tilt. Skeletal muscle vascular resistance was reduced in the fosinopril group (46 +/- 6 to 30 +/- 1 mm Hg.mL-1.100 g.min +/- standard error; P < .05) and differed compared with the effect of placebo (P < .05) where no change was seen (37 +/- 11 to 55 +/- 13 mm Hg.mL-1.100 g.min; not significant [NS]). Also, skin minimal vascular resistance was reduced during fosinopril treatment (13 +/- 0.6 to 11 +/- 0.7 mm Hg.mL-1.100 g.min; P < .05) and differed compared with the effect of placebo (P < .05) with absence of change (12 +/- 1.6 to 14 +/- 1.4 mm Hg.mL-1.100 g.min; NS). CONCLUSIONS: These results suggest that long-term ACE inhibitor treatment with fosinopril in patients with CHF improves hemodynamic status to as far as the peripheral microvascular level in both the relaxed and nonrelaxed microcirculation of the lower leg.
机译：背景：在充血性心力衰竭（CHF）中使用血管紧张素转换酶（ACE）抑制剂进行治疗可改善心脏和外周血流动力学功能和运动表现。然而，缺乏对ACE抑制剂长期治疗对CHF的神经原性和非神经原性调节以及外周微血管结构微血管病变的影响的研究。方法和结果：在一项由安慰剂对照的12例患者和10例安慰剂治疗的双盲安慰剂对照研究中，我们研究了ACE抑制剂福辛普利治疗12周对外周微血管功能的影响。所有患者均患有中度瑞士法郎。在局部仰卧位和抬头倾斜状态下，在放松和无松弛的小腿血管床中应用局部同位素冲洗法后，计算微血管的血流和阻力。福辛普利组的骨骼肌血管阻力降低（46 +/- 6至30 +/- 1 mm Hg.mL-1.100 g.min +/-标准误差; P <.05），与安慰剂相比有所不同（P <.05），未见变化（37 +/- 11至55 +/- 13 mm Hg.mL-1.100 g.min;无显着性[NS]）。此外，在福辛普利治疗期间皮肤最小血管阻力降低（13 +/- 0.6至11 +/- 0.7 mm Hg.mL-1.100 g.min; P <.05），并且与安慰剂的效果有所不同（P <。 05）不变（12 +/- 1.6至14 +/- 1.4 mm Hg.mL-1.100 g.min; NS）。结论：这些结果表明，福辛普利对慢性心力衰竭患者进行长期ACE抑制剂治疗，可改善小腿松弛和非松弛微循环的血液动力学状况，直至外周微血管水平。

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