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Effects of perindopril on levels of endothelial dysfunction biomarkers in chronic heart failure patients with mid-range ejection fraction after 12-month therapy

Session Poster Session 3

Speaker Associate Professor Irina Ilgisonis

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : I Ilgisonis (Moscow,RU), YU Danilogorskaya (Moscow,RU), E Zheleznykh (Moscow,RU), YU Belenkov (Moscow,RU), M Kozhevnikona (Moscow,RU), G Shakaryants (Moscow,RU), A Shchendrigina (Moscow,RU), E Privalova (Moscow,RU)

I Ilgisonis1 , YU Danilogorskaya1 , E Zheleznykh1 , YU Belenkov1 , M Kozhevnikona1 , G Shakaryants1 , A Shchendrigina1 , E Privalova1 , 1I.M. Sechenov First Moscow State Medical University - Moscow - Russian Federation ,


Background. The pathogenesis and progression of chronic heart failure is associated with endothelial dysfunction and severe cardiovascular remodeling. Thus, correction of these important processes may improve the course of the disease and long-term outcomes.
Purpose. To evaluate effects of perindopril A long-term therapy on endothelial dysfunction biomarkers in patients with chronic heart failure with mid-range ejection fraction (HFmrEF).
Methods. Thirty patients with HFmrEF of II-III functional class (NYHA) were enrolled in the study (men/women = 20/10; average age 65 (61;72) years old; duration of HF – 6 (3; 9) years; average body mass index 27.7 (25.3;30.8) kg/sqm) of ischemic etiology (coronary artery disease duration – 10 (5; 17) years; myocardial infarction - 20 patients (64%)). HFmrEF was verified by transthoracic echocardiography (average EF 46% (44; 49); average NT-proBNP levels 215 (135;256) pg/ml). The cohort was represented by patients with II NYHA class (n=18, 60%) and III NYHA class (n=12, 40%). All patients underwent specific laboratory testing by ELISA for identification of biomarkers of endothelial dysfunction and vessel remodeling (metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1), E-selectin, endothelin-1 (ET-1), transforming growth factor ß1 (TGF-ß1), vessel endothelial growth factor A (VEGF A)) before and after 12-month treatment with perindopril A 10 mg/d.
Results. After 12-month treatment of HFmrEF patients with perindopril A in the maximum tolerated dose of 5 mg/day (n=19) and 10 mg/day (n=11) a significant decrease of MMP-9 level was observed: from 209.5 ng/ml (145.75;266.75) to 157 ng/ml (116.5;221.75) (p<0.05), N up to 134 ng/ml; while the level of TIMP-1 did not significantly change. A significant decrease also was noted in the level of E-selectin from 42.7 ng/ml (30.2;62.88) to 35.7 ng/ml (24.1;47.95) (p<0.05), N 21-186 ng/ml; as well as the level of growth factors: VEGF-A from 156 ng/ml (9.05;271,7) to 34,85 ng/ml (8.05;142.28) (p<0.05), N up to 128 ng/ml, TGF- ß1 from 24665 pg/ml (5136.5;5300.25) to 14637 pg/ml (5300.25; 29354) (p<0.05), N 5222-13731 pg/ml. The level of ET-1 decreased from 0.845 ng/ml (0.43;1.45) to 0.735 ng/ml (0.4125;1.3775), (p <0.05), N less than 0.26 ng/ml. The change in the level of these indicators was associated with a significant increase in the left ventricular EF from 46% (44;49) to 49.5% (48;54) (p <0.05).
Conclusion. 12-month therapy with perindopril A 5-10 mg/day was associated with significant decrease of the analyzed biomarkers, thus improving endothelial function, vessel remodeling and myocardial contractility in HFmrEF patients.

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