Abstract:
Introduction. According to various literature data, angiotensin-converting enzyme inhibitors (ACE
inhibitors) are considered effective, safe and well-tolerated drugs in children and adolescents, despite the
inconsistency and lack of sufficient evidence for their use. ACE inhibitors in pediatrics can be used in the
treatment of arterial hypertension, heart failure, various congenital heart abnormalities, chronic kidney
disease with massive proteinuria, glomerulonephritis and diabetes. The most commonly used ACE
inhibitors in children and adolescents are Captopril and Enalapril, but it is also possible to use Lisinopril,
Ramipril, Fosinopril, Quinapril.The use of this group of drugs in children and adolescents requires
compliance with the recommended dosage and careful monitoring of the patient's condition due to a greater
exposure to the risk of side effects than in adults. The recommended dose in children and adolescents for
captopril are 0.3-0.5 mg/kg/day divided into 2-3 doses(maximum 6 mg/kg/day; 40 mg/day) and enalapril
0.08 mg/kg/day(maximum 0.6 mg/kg/day ; up to 5 mg per day).Enalapril is not recommended for neonates
or children with glomerular filtration rate <30 mL/min/1.73m².
Aim of study. To identify and analyse the clinical efficacy of ACE inhibitors in pediatric cardiology for
various heart pathologies in children and adolescents.
Methods and materials. In a retrospective study, data were processed from 598 (100%) inpatient medical
records of cardiac patients in the age category of 1-18 years with various heart pathologies treated in the
period 2020-2021 at the Children's Municipal Clinical Hospital named after V. Ignatenko in Chisinau.
Results. As a result of the study, it was found that 87% of cases were emergency hospitalizations.
Pharmacotherapy analysis showed that ACE inhibitors (captopril or enalapril) were used in 33.74% of
cases. Of these, 13.37% were associated with congenital heart defects, 1.5% with non-rheumatic
myocarditis, 1.83% with mitral valve prolapse, 3.34% with post-infectious cardiopathies, 8.02% with
arterial hypertension, and 5.68% with various degrees of heart failure. Doses of drugs depending on the
diagnosis, purpose of use, and different age categories were:1 mg/kg / day for captopril, 0.02-0.05 mg/
kg/day for enalapril, and for hypertension in children over 6 years of age, depending on body weight: 0.625-
1.25 mg/kg/day. The duration of treatment was 5-10 days.
Conclusion. This study of the use of ACE inhibitors in pediatric cardiology for various heart pathologies
demonstrated high efficacy and safety due to the absence of side effects. There was a significant
improvement in the condition of patients and an increase in exercise tolerance during treatment with ACE
inhibitors at recommended doses due to vasodilating and cardioprotective properties.
