Shapovalova S. Metabolic effects of angiotensinconverting enzyme inhibitors at dysfunction of the left ventricle in patients with essential hypertension

The dissertation is devoted to the problems of improvement of the efficacy of diagnosis hypertensive heart dysfunction and treatment of the patients with hypertensive disease with enalapril maleat with evaluation of its complex influence on the structural functional features of the myocardium and activity of metabolic and neurohumoral processes in patients with different clinical course of disease. 120 patients with essential hypertension have been established by general clinical methods of investigation echocardiography, biochemical and radioimmunologic methods. The similarity between the metabolic changes and processes of hypertensive remodelling of the myocardium was analyzed. Biochemical markers of dysfunction and structural reconstraction of the myocardium in hypertensive patients were established. The effect of enalapril on exchange processes consists of activation of the antioxidant system, inhibition of redundant production of lipid peroxidation, optimization of bioenergetic processes. Influenc e of enelapril on structural-functional state of the myocardium is in decrease of volumetric parameters of the left ventricle and increase of indexes of myocardium contractility. Metabolic effects of enalapril was used to validate ACE inhibitor administration on as pathogenetic therapy preparation with metabolic effect. Clinical, hemodynamic and biochemical criteria of prognosis and evaluation of the treatment efficacy in hypertensive patients were determined.