Microcirculatory Disturbances and Their Correction by Angiotensin-Converting Enzyme Inhibitor Lisinopril in Patients with Coronary Heart Disease Combined with Diabetes Mellitus Type 2

Abstract

A coronary heart disease and diabetes mellitus type 2 are the most complicated and urgent problem of medical science and public health. The standard therapeutic measures in some cases do not provide significant clinical improvement of patients with a stable course of the disease. This requires further study of the pathogenesis of the heart and vessels lesions in patients with combined pathology and the search for new medicines. In this work, the authors studied the state of microcirculation with the morphological assessment of the microvascular bed, considering the effectiveness of therapeutic effects of angiotensin-converting enzyme inhibitor lisinopril a daily dose of 5 mg in patients with ischemic heart disease (IHD), stable angina ΠΙ FC in combination with type 2 diabetes. Baseline, after 1 and 6 months of treatment, the authors conducted a conjunctival biomicroscopy of the eye vessels with a caliber measurement and mor-phometric analysis. The results of the study were the following: the combination of IHD and type 2 diabetes forms the gross disorders of microcirculation. This is reflected in the development of widespread perivascular edema, multiple hemorrhages, sudden depletion of the vascular bed with nonvascular lesions, intravascular aggregation of erythrocytes -"sludge-phenomenon". The prolonged complex use of lisinopril caused the positive dynamics of microcirculatory disorders, in particular, intravascular link with increasing flow velocity and decreasing the aggregation of erythrocytes. This is the basis for recommendations to the widespread use of this drug in this combined pathology.