Evaluation of the influence of the therapy with fosinopril and zofenopril on the regulatory-adaptive status of patients with diastolic chronic heart failure

Aim. Еvaluate the influence of combination therapy with fosinopril or zofenopril on the regulatory-adaptive status (RAS) of patients with diastolic chronic heart failure (CHF). Material and methods. The study includes 80 patients with CHF I-II functional class according to the classification of the New York heart Association with left ventricle ejection fraction ≥50% because of hypertensive disease (HD) of III stage, who were randomized into two groups for treatment with fosinopril (14.7±4.2 mg/day, n=40) or zofenopril (22.5±7.5 mg/day, n=40). As part of combination pharmacotherapy, patients were included nebivolol (7.1±2.0 mg/day and 6.8±1.9 mg/day), in the presence of indications, atorvastatin and acetylsalicylic acid in the intestinal shell were prescribed. Initially and after six months, the following was done: a quantitative evaluation of the RAS (by cardio-respiratory synchronism test), echocardiography, tredmil-test, six-minute walking test, determination of the N-terminal precursor of the natriuretic brain peptide level in blood plasma and subjective evaluation of quality of life. Results. Therapy, using fosinopril, in comparison with zofenopril, more improved RAS (by 66.5%, p<0.01 and 50.6%, p<0.01). In the group of fosinopril more pronounced increased tolerance to physical activity: increased test distance with a six-minute walk (by 27.2%, p<0.05 and 24.3%, p<0.05), decreased functional class of CHF (from II to I in 57% of patients, in 17% of cases of CHF was not registered and from II to I in 29% of patients, in 11% of cases of CHF was not registered) respectively. In both groups, a comparable improvement in cardiac diastolic function was observed (decreased VE/Ve´ by 37.8%, p<0.01 and 36.3%, p<0.01), reduction of neurohumoral hyperactivity (NT-proBNP decreased by 40.9%, p<0.01 and 37.3%, p<0.01), improving the quality of life (decrease in the amount of negative points by 69.5%, p<0.01, and 64.9%, p<0.01) respectively. The data obtained were not compared with the control group. Conclusion. In patients with diastolic CHF because of HD III stage as part of the combination pharmacotherapy, the use of fosinopril, in comparison with zofenopril, may be preferable because of a more pronounced positive influence on RAS.

regulatory-adaptive status, chronic heart failure, fosinopril, zofenopril