Delevskaya V.Y.
The influence of spironolactone on extracellular matrix metabolism in patients with arterial hypertension and concomitant chronic obstructive pulmonary disease
Kharkiv National Medical University, the Ukraine
Abstract.
Objectives. To study the effect of aldosterone receptors blockade on extracellular matrix metabolism in patients with arterial hypertension combined with chronic obstructive pulmonary disease.
Material and methods. A total of 80 patients with arterial hypertension combined with chronic obstructive pulmonary disease of II-III degree of airways obstruction were included in the study. All patients were divided into 2 groups. The first group (41 patients) received basic therapy and the second group (39 patients) additionally received spironolactone in a daily dose of 50 mg during 3 months. Thw level of glycosaminoglycanes in the blood serum of patients was measured by resorcin method and MMP-9 – by enzyme-linked immunosorbent assay. All patients underwent laboratory investigation before and after the treatment.
Results. The obtained results have shown, that the addition of spironolactone to the basic treatment of patients with arterial hypertension and chronic obstructive pulmonary disease led to the decreased level of serum chondroitin-6-sulphates and the increased level of heparansulfates/keratansulfates, which was accompanied by the decrease of MMP-9 level in the blood serum (p<0,05). No adverse effects while using spironolactone were registered in the studied patients.
Conclusions. The addition of spironolactone to the basic treatment of heart failure in the patients with arterial hypertension and chronic obstructive pulmonary disease results in positive changes of ECM metabolism and the reduction in the activity of connective tissue degradation processes, that might contribute to the positive effect of spironolactone on cardiovascular system and progression of heart failure.
Key words: spironolactone, glycosaminoglycanes, matrix metalloprotease-9, chronic obstructive pulmonary disease, arterial hypertension.
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