Research on the preventive effect of oral captopril on the pulmonary arterial hypertension associated with ventricular septal defect

doi:10.19538/j.ek20170806011

Abstract：Objective To explore the preventive effect of regular doses of captopril on the pulmonary arterial hypertension associated with ventricular septal defect (VSD) and its mechanism.Methods Forty cases of children with VSD in accordance with the inclusive criteria,who were hospitalized in Chengdu Women and Children's Central Hospital from July 2013 to July 2015,were collected and randomly divided into blank control group (n =20)and captopril intervention group (n =20).Plasma MMP-9 and TIMP-1 were examined by using ELISA,and PASP,the Qp/Qs and right ventricular Tei index were measured by cardiac color Doppler ultrasound at 0 week,1 week,4 weeks,8 weeks,and 12 weeks respectively;side effects in captopril intervention group were also observed.Results PASP,the Qp/Qs,right ventricular Tei index,plasma MMP-9 and TIMP-1 level in blank control group were increased over time;the same indexes in captopril intervention group were decreased,the changing trend of two groups had statistically significant difference (all P ＜ 0.05).The indexes were of no difference between the two groups at 0 week(all P ＞ 0.05);PASP and right ventricular Tei index in captopril intervention group were lower than blank control group at 1 week,4 weeks,8 weeks,and 12 weeks (all P ＜ 0.05);the Qp/Qs plasma,MMP-9 and TIMP-1 level in captopril intervention group were lower at 4 weeks,8 weeks,and 12 weeks (all P ＜ 0.05).No side effects were found in captopril intervention group during follow-up.Conclusion Oral regular doses of captopril in the VSD children undergoing elective surgery may reduce pulmonary vascular remodeling and prevent pulmonary hypertension in order to achieve the best age at surgery;one of the mechanisms might be improving indexes of PASP,right ventricular Tei index and the Qp/Qs by reducing the plasma MMP 9 and TIMP-1 level.