Влияние карведилола и бисопролола на дисфункцию эндотелия у больных хронической сердечной недостаточностью

Аннотация

Subjects of the inquiry: 100 patients with postinfarction cardiosclerosis (PICS) complicated by I-III functional classes (FC) chronic heart failure (CHF) during 6 months have been observed. Aim of inquiry: to evaluate comparative clinical-hemodynamic efficacy of carve-dilol and bisoprolol on postinfarction remodeling processes in left ventricle (LV) and endothelial dysfunction of patients with PICS complicated by I-III FC CHF. Method of inquiry: test of six minutes’ walking (TSW), Scale of an estimation of a clinical condition (SECC), investigating of the quality of life (QL), echocardiography, dopplcrography of humeral artery was performed with assessment of flow-dependent in the probe with reactive hyperemia and nitroglycerin (NGT), platelet aggregation and the level factor of fon Willebrand in the blood scrum. The results achieved and their novelty: Complex assessment of clinical state, tolerance of patients to physical loading, QL, SECC, hemodynamic parameters, structural-geometrical indices of postinfarction cardiac RLV and parameters of endothelial dysfunction have been conducted. The carried out study results showed the association of postinfarction remodeling of LV processes and remodeling of vessels provided by ncu-rohumoral system activation. A reliable effect of carvcdilol and bisoprolol on tolerance to physical loading, QL parameters, hemodynamic indices, structural-geometrical heart parameters, contractility of the myocardium in LV for prolonged six months therapy pronounced. A reliable improvement of endothelial dysfunction and characterized by endothelial depended vasodilatation, decreased vessel tone, platelet aggregation and the level factor of fon Willebrand in patients with I-II FS CHF, by effect of prolonged therapy with carvcdilol and bisoprolol was proved. Carvcdilol effected positively on parameters of endothelial dysfunction in patients with III FS CHF. Practical value: It has been revealed the functional, humoral markers of endothelial dysfunction and parameters of remodeling in patients with CHF. Definition of functional and humoral endothelial markers functions can optimize early diagnostics in postmyo-cardial infarction patients. Parameters to differential administration beta adrcnoblockcrs depending on endothelial dysfunction with LV remodeling relationship have been developed. Degree of embed and economic effectivity: results and conclusions of research arc introduced into practice of work in the department of Cardiology at the 1st clinic of the Tashkent Medical Academy, an Information Letter has documented. Sphere of usage: departments of Therapy, Cardiology, Functional Diagnostics of clinics.