Captopril and perindopril effects on central and peripheral hemodynamics in chronic cardiac failure

Right heart catheterization was used for investigation of effects of angiot ensin converting enzyme inhibitors on central hemodynamics in 37 patients w ith chronic heart failure due to postinfarction cardiosclerosis. Studies we re done during acute drug test and 4 weeks of treatment with captopril (23 patients, 75-100 mg/day) or perindopril (14 patients, 4 mg/day). In acute t est both drugs produced favorable hemodynamic effects. But during course tr eatment <<escape>> of clinical and hemodynamic effects of captopril in was observed in 34,8% of patients while effects of perindopril persisted throug hout period of therapy. Peripheral blood flow in vessels of forearm microci rculation was assessed by laser doppler flowmetry. Perindopril caused signi ficant increases in peripheral perfusion, amplitude of slow and pulse oscil lations of blood flow. it also promoted restoration of response of microcir culatory Vessels to sympathetic activation and stimulation of venulo-arteri olar reactions, Such common side effect of angiotensin converting enzyme in hibitors as cough was not registered in perindopril but not captopril treat ed patients.