Transpulmonary Angiotensin II Formation in Patients with Chronic Stable Cor Pulmonale^1,2

Effects of captopril in patients with chronic obstructive pulmonary disease and secondary pulmonary hypertension

“…Although hypoxia inhibits ACE activity, the gross elevation of plasma renin activity observed in patients with chronic hypoxia may still cause increased angiotensin II levels.7 Apparent reduction in ACE activity has been demonstrated on ascent to high altitude18 and in patients with cor pulmonale and respiratory failure caused by COPD. 19 There was a tendency for cardiac output to fall in our patients and coronary flow to the right ventricle was reduced in them after captopril. Ischaemia of the right ventricular myocardium is a limiting factor in response to pressure load and that can contribute to the fall of cardiac output.…”