Effect of angiotensin-converting enzyme inhibitors on the state of microcirculation in patients with chronic heart failure

Left forearm cutaneous microcirculation was assessed by laser doppler flowm etry in 32 patients with NYHA class II-IV congestive heart failure after my ocardial infarction. Studies were done at rest and after respiratory, postu ral and occlusive tests before and after 4 weeks of treatment with an angio tensin converting enzyme inhibitor. It was shown that index of microcircula tion, amplitudes of vasomotion and of cardiorhythms, reactions of periphera l blood now to respiratory and postural tests decreased with progression of heart failure. Fourteen patients received perindopril (4 mg/day) and 18 pa tients - ramipril (5 mg/day). Both perindopril and ramipril increased index of microcirculation (by 19,4, p<0,05, and 25%, p<0,01, respectively) and a mplitude of vasomotion (by 43,4 and 64,6%, p<0,05, respectively). Perindopr il compared with ramipril to a greater extent augmented amplitude of cardio rhythms (by 100,8, p<0,001, and 31,6%, p<0,05, respectively). Perindopril b ut not ramipril restored depressed reactions during respiratory and postura l tests.