Importance of angiotensin-converting enzyme in pulmonary hypertension

William T. Abraham, Mary V. Raynolds, Brigitte Gottschall, David B. Badesch, Kristine M. Wynne, Bertron M. Groves, Brian D. Lowes, Michael R. Bristow, M. Benjamin Perryman, Norbert F. Voelkel

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Angiotensin II causes pulmonary vasoconstriction in man and in animals, and angiotensin-converting enzyme (ACE) inhibitors have prevented the development of chronic pulmonary hypertension in animal models. Angiotensin II may contribute to lung vascular remodeling in pulmonary hypertensive disease, since cilazapril, an inhibitor of ACE, reduces pulmonary vascular medial thickening in chronically hypoxic rats with established pulmonary hypertension. Furthermore, the ACE DD genotype, which has been associated with increased circulating and tissue ACE activity, has been associated with left ventricular hypertrophy in human hypertensive disorders. The ACE DD genotype may also ‘permit’ a greater hypertrophic adaptation of the pressure-overloaded right ventricle. In fact, we have shown that pulmonary hypertension patients with maintained cardiac output and less right-heart failure fall into the group with the DD genotype and that patients with a low cardiac output and more severe right-heart failure fall into the group with the non-DD genotype, supporting the hypothesis. We assessed cardiopulmonary hemodynamics in patients with primary (unexplained) pulmonary hypertension and segre-gated the patients based on their ACE genotype. For similar mean pulmonary artery pressures in the DD and non-DD groups, the cardiac output was substantially lower in the patients with the non-DD genotype, whereas the values for mean right atrial pressure and pulmonary vascular resistance were double when compared with the DD group. Our data show that the ACE DD genotype is prevalent in patients with severe pulmonary hypertension and is a marker of maintained right ventricular function.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalCardiology (Switzerland)
Volume86
DOIs
StatePublished - Jan 1 1995

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Peptidyl-Dipeptidase A
Pulmonary Hypertension
Genotype
Angiotensin-Converting Enzyme Inhibitors
Angiotensin II
Cardiac Output
Lung
Cilazapril
Heart Failure
Low Cardiac Output
Pressure
Right Ventricular Function
Atrial Pressure
Left Ventricular Hypertrophy
Vasoconstriction
Vascular Resistance
Pulmonary Artery
Lung Diseases
Heart Ventricles
Blood Vessels

Keywords

  • ACE genotype
  • Hypoxia
  • Pulmonary hypertension
  • Right heart failure
  • Right ventricular hypertrophy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

Cite this

Abraham, W. T., Raynolds, M. V., Gottschall, B., Badesch, D. B., Wynne, K. M., Groves, B. M., ... Voelkel, N. F. (1995). Importance of angiotensin-converting enzyme in pulmonary hypertension. Cardiology (Switzerland), 86, 9-15. https://doi.org/10.1159/000176939

Importance of angiotensin-converting enzyme in pulmonary hypertension. / Abraham, William T.; Raynolds, Mary V.; Gottschall, Brigitte; Badesch, David B.; Wynne, Kristine M.; Groves, Bertron M.; Lowes, Brian D.; Bristow, Michael R.; Perryman, M. Benjamin; Voelkel, Norbert F.

In: Cardiology (Switzerland), Vol. 86, 01.01.1995, p. 9-15.

Research output: Contribution to journalArticle

Abraham, WT, Raynolds, MV, Gottschall, B, Badesch, DB, Wynne, KM, Groves, BM, Lowes, BD, Bristow, MR, Perryman, MB & Voelkel, NF 1995, 'Importance of angiotensin-converting enzyme in pulmonary hypertension', Cardiology (Switzerland), vol. 86, pp. 9-15. https://doi.org/10.1159/000176939
Abraham WT, Raynolds MV, Gottschall B, Badesch DB, Wynne KM, Groves BM et al. Importance of angiotensin-converting enzyme in pulmonary hypertension. Cardiology (Switzerland). 1995 Jan 1;86:9-15. https://doi.org/10.1159/000176939
Abraham, William T. ; Raynolds, Mary V. ; Gottschall, Brigitte ; Badesch, David B. ; Wynne, Kristine M. ; Groves, Bertron M. ; Lowes, Brian D. ; Bristow, Michael R. ; Perryman, M. Benjamin ; Voelkel, Norbert F. / Importance of angiotensin-converting enzyme in pulmonary hypertension. In: Cardiology (Switzerland). 1995 ; Vol. 86. pp. 9-15.
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