Inhibitors angiotensin converting enzyme (renitec) and antagonists of receptors angiotensin II (cozaar) have largely revolutionized in the treatment of cardiovascular diseases. Among them are arterial hypertension, congestive heart failure, ischemic heart disease, arrhythmia. The drugs were useful in the treatment of left ventricular dysfunction in patients with myocardial infarction, chronic forms of ischemic heart disease. The effect of inhibitors angiotensin converting enzyme on the heart and blood vessels is due to: 1) the effect on the heart structure (prevention of dilated cavities, improvement of pumping function, reduction of myocardial hypertrophy); 2) improvement of coronary blood supply (prevention of vasoconstrictive effect of angiotensin II); 3) prevention of heart rhythm disturbances associated with ventricular hypertrophy, hypokalemia, excess of catecholamines. The aim of the investigation was to study antiarrhythmic efficacy of ACE inhibitor of Renetic and antagonist of receptors of angiotenzinII Cozaar. Materials and methods. A clinical study of renitec was performed in 42 patients with chronic ischemic heart disease (32 men, 10 women). The age was 45 years - 4 (9.5%), and from 45 to 59 years - 24 (57.1%), from 60 to 74 years - 11 (26.2%), older than 74 years included 3 patients (7.1%). Results. Renitec for relief of rhythm disturbances was applied depending on the situation for 10-20 mg 1-2 times a day. The daily dose of oral administration was 10-40 mg (1-4 tablets) for 7-20 days and depended on its antiarrhythmic effect and the clinical condition of the patient. Supportive therapy in a dose of 5-10 mg of renitec lasted up to 2 weeks. Clinical efficacy of cozaar was studied in 32 patients (21 men and 11 women) with cardiac arrhythmias in chronic ischemic heart disease at the age of 30 to 80 years. Up to 45 years there were 3 people (9.4%), 11 (34.4%) included from 45 to 59 years old, 12 (39.1%) included patients from 60 to 74 years, over 74 there were 6 patients (17.2 %). Cozaar was used in a dose of 50-100 mg per day. The initial daily dose was 50 mg, in the absence of effect after 3-6 days the dose of the drug was increased to 100 mg per day. The drug was used for 7-21 days. Conclusions. Thus, the most pronounced antiarrhythmic effect of renitec was seen in patients with chronic ischemic heart disease with supraventricular, ventricular extrasystole and sinus tachycardia. The antiarrhythmic effect of the goat is more pronounced in order of preference for ventricular extrasystole, as well as fibrillation and atrial flutter, frequent supraventricular extrasystole. Cozaar, according to our data, reduces the effect of angiotensin II on the renin-angiotensin-aldosterone system, the function of the adrenal glands, normalizes the ratio of sodium and potassium inside and outside the cell, increases the content of cyclic nucleotides, reduces the content of free fatty acids, thereby causing an antiarrhythmic effect.
Full text: PDF (Rus) 182K