Hypertension of Both the Pulmonary and Systemic Circulations and the Vasodilator Properties of L-Arginine (Acute Drug Testing)

The article highlights the problems of the correction of endothelial dysfunction and peripheral hemodynamics of both the pulmonary and systemic circulations in patients with arterial hypertension (AH) stage II and co-existent chronic obstructive pulmonary disease (COPD) by acute intravenous L-arginine infusion. Materials and methods. 20 patients with AH stage II and co-existent COPD in remission phase without respiratory failure with the average age of 48±3.9 years (males to females = 1:1) suffering from pulmonary hypertension of bronchopulmonary genesis (the main group) who received L-arginine and 10 patients of corresponding age and gender who were injected a solution of 0.9% sodium chloride (the control group) were included in the study. Intravenous infusions (4.2% L-arginine hydrochloride and saline solutions) were performed once using acute drug testing at the rate of 10 drops per minute within the first 10 minutes and increasing the drip rate by 15 drops per minute. Results. An expressive hypotensive effect in case of acute administration of L-arginine in the systemic circulation during the infusion and over the next 24 hours with a reduction in both systolic and diastolic blood pressure was noted. The pressure in the pulmonary artery had a tendency to decrease over the next 24 hours. When performing Celermaier ? Sorensen test an increase in brachial artery diameter before and after the exposition to air and reduction in intima-media thickness were detected. Conclusions. L-arginine hydrochloride has a synchronous hypotensive effect on the hypertension of both the pulmonary and systemic circulations and is involved in the functional correction of endothelial dysfunction. It can be used in the complex treatment of patients with AH with co-existent COPD.