Influence of Lisinopril and Losartan on Parameters of Cardiac Hemodynamics and Kidney Function in Patients with Congestive Heart Failure

The purpose of the present research was to study the comparative influence of lisinopril and losartan on the parameters of cardiac hemodynamics and kidney function state in CHF (Congestive Heart Failure) patients with NYHA Functional Class (FC) I-III. Methods: The study included 92 CHF patients aged from 41 to 75 years (mean age 66.3±9.8 yrs) with FC I-III of ischemic genesis. The patients were divided into two groups. Group I consisted of 47 CHF patients with FC I-III who had been receiving losartan for 6 months in addition to standard therapy. Group II consisted of 45 CHF patients with FC I-III who had been receiving lisinopril for 6 months in addition to standard therapy. The dose of losartan was 50–100 mg/day, and lisinopril, 5–10 mg/day. The control group included 20 healthy volunteers. NYHA FC was determined by the 6-minute walk test (6MWT) and the Russian scale of evaluation of the clinical condition of the patients. All patients underwent clinical examination, ECG, and echocardiography. Estimated creatinine clearance rate (eCCr) was calculated using the Cockcroft-Gault formula; estimated glomerular filtration rate (eGFR) was calculated using the MDRD formula. Results: The results obtained show a clear association between maladaptive LV remodeling and kidney dysfunction at CHF. Our analysis revealed the significant direct correlation between EF and eGFR, as well as between 6MWT and eGFR. The 6-month therapy of CHF patients with NYHA FC I-III based on a combination of standard therapy with ACEi/ARB has resulted in a significant improvement in the cardiac hemodynamic, LV myocardial contractility, and renal function, with a more significant effect in the patients treated with losartan.