Hypertension of Both the Pulmonary and Systemic Circulations and the Vasodilator Properties of L-Arginine (Acute Drug Testing)
PDF

Keywords

arterial hypertension
chronic obstructive pulmonary disease
endothelial dysfunction
L-arginine

Abstract

The article highlights the problems of the correction of endothelial dysfunction and peripheral hemodynamics of both the pulmonary and systemic circulations in patients with arterial hypertension (AH) stage II and co-existent chronic obstructive pulmonary disease (COPD) by acute intravenous L-arginine infusion. Materials and methods. 20 patients with AH stage II and co-existent COPD in remission phase without respiratory failure with the average age of 48±3.9 years (males to females = 1:1) suffering from pulmonary hypertension of bronchopulmonary genesis (the main group) who received L-arginine and 10 patients of corresponding age and gender who were injected a solution of 0.9% sodium chloride (the control group) were included in the study. Intravenous infusions (4.2% L-arginine hydrochloride and saline solutions) were performed once using acute drug testing at the rate of 10 drops per minute within the first 10 minutes and increasing the drip rate by 15 drops per minute. Results. An expressive hypotensive effect in case of acute administration of L-arginine in the systemic circulation during the infusion and over the next 24 hours with a reduction in both systolic and diastolic blood pressure was noted. The pressure in the pulmonary artery had a tendency to decrease over the next 24 hours. When performing Celermaier – Sorensen test an increase in brachial artery diameter before and after the exposition to air and reduction in intima-media thickness were detected. Conclusions. L-arginine hydrochloride has a synchronous hypotensive effect on the hypertension of both the pulmonary and systemic circulations and is involved in the functional correction of endothelial dysfunction. It can be used in the complex treatment of patients with AH with co-existent COPD.
PDF

References

Bobrov V.A., Firsova I.G. Nitric oxide metabolism and endothelial dysfunction in patients suffering from essential hypertension with signs of left ventricular remodeling. Ukr. kardiol. zh. 2010; 3: 58-63.

Voloshina I.N. The relationship between proinflammatory activation and severity of hypertension and possibilities of therapeutic correction. Zaporosh. med. zh. 2010; 12: 18-22.

Havrysiuk V.K. Chronic pulmonary heart disease: mechanisms of pathogenesis and principles of therapy. Ukr. pulmonol. zhurn. 2006; 4: 6-13.

Deineha V.H., Kryvenko V.V. The morphofunctional state of the heart, vessels and endothelial function in patients with chronic obstructive pulmonary disease and co-existent arterial hypertension. Buk. med. visnyk. 2013; 2(66): 41-45.

Zagidullin N.Sh., Valeeva K.F., Gassanov N. et al. The role of endothelial dysfunction in cardiovascular diseases and methods of its therapeutic correction. Kardiologiya. 2010; 5: 54-60.

Kramareva V.N. Endothelial function in patients with essential arterial hypertension at different levels of cardiovascular risk. Ukr. kardiol. zh. 2010; 2: 43-45.

Kryvenko V.V. Systemic inflammation and morphofunctional parameters of the myocardium and vessels in patients with chronic obstructive pulmonary disease and co-existent arterial hypertension. Zaporozh. med. zh. 2013; 3(78): 43-46.

Mostovoy Yu.M. Current problems of the pathogenesis, diagnostics and treatment of pulmonary hypertension. Liky Ukraiiny. 2005; 9: 33-37.

Mukharlyamov N.M., Sattbekov Zh.S., Suchkov V.V. Systemic arterial hypertension in patients with chronic nonspecific lung disease. Kardiologiya. 1974; 12(34): 55-61.

Ostrovskyi M.M., Gerych P.R. The issue o of polymorbidity and comorbidity in patients with COPD. Ukr. pulmonol. zh. 2011; 4: 19-24.

Potabashnii V.A. Central hemodynamics in chronic heart failure associated with ischemic heart disease and arterial hypertension with co-existent chronic obstructive pulmonary disease. Aktualni pytannia medychnoii nauky ta praktyky: Zb. nauk. prats. 2007; 71(2); 39-45.

Steshina T.E., Chesnikova A.I., Terentyev V.P. Circadian blood pressure profile in patients with arterial hypertension and co-existent chronic obstructive pulmonary disease. Ros. kardiol. zhurn. 2005; 4: 24-29.

Feshchenko Yu.I. Relevant problems of diagnosis and treatment of COPD with comorbidity. Ukr. pulmonol. zh. 2009; 2: 6.

Yachnyk A.I. COPD and hypertensive disease: current state and modern approaches to therapy. Ukr. pulmonol. zh. 2009; 2: 9.

Barnes P.J., Cosio M.G. Cells and mediators of chronic obstructive pulmonary disease. Eur. Respir. Monogr. 2006; 38: 130-158.

Brook R.D., Julius S. Autonomic imbalance, hypertension, and cardiovascular risk. American Journal of Hypertension. 2000; 13(6): 112-S122.

Falk J.A., Kadiev S., Criner G.J. et al. Cardiac disease in chronic obstructive pulmonary disease. Proc. Am. Thorac. Soc. 2008; 5: 543-548.

Divo M., Cote C., Torres J.P. et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care. Med. 2012; 186: 155-161.

Heitzer T., Schlinzig T., Krohn K et al. Endothelial dysfunction, oxidative stress and risk of cardiovascular events in patients with coronary disease. Circulation. 2001; 104: 263—268.

Huiart L., Ernst P., Suissa S. Cardiovascular morbidity and mortality in COPD. Chest. 2005; 128: 2640-2646.

Yao H., Rahman I. Current concepts on oxidative/carbonyl stress, inflammation and epigenetics in pathogenesis of chronic obstructive pulmonary disease. Toxicology and Applied Pharmacology. 2011; 254: 72-85.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Downloads

Download data is not yet available.