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Aim. To study laboratory and magnetic resonance imaging (MRI) characteristics of infarction area depending on left ventricular (LV) global systolic function in patients with acute myocardial infarction (AMI) after revascularization.Material and methods. A total of 78 patients with primary AMI were included. On days 7-10, contrast-enhanced cardiac MRI was performed. Blood brain natriuretic peptide (BNP) was analyzed. Cardiac MRI was used to determine the characteristics of scar tissue, peri-infarct zone (PIZ), microvascular obstruction (MVO), intramyocardial hemorrhage (IMH) and the global contrast index.Results. According to the MRI, patients were divided into following groups: group 1 — LV ejection fraction (LVEF) ≥50% (n=50), group 2 — LVEF 40-49% (n=21), group 3 — LVEF

Aim. To search early signs of cardiotoxicity in patients receiving anticancer therapy and evaluate the effectiveness of cardioprotection with an angiotensin-converting enzyme inhibitor, beta-blocker and myocardial cytoprotector.Material and methods. The study included 98 patients with high and very high risk of cardiotoxicity according to the Mayo Clinic scale (USA). Cancer patients with hypertension were offered cardioprotective treatment with a fixed-dose combination of perindopril and bisoprolol, and patients with very high risk and concomitant coronary artery disease additionally trimetazidine.The patients were divided into 2 following groups: the experimental group (n=50), where patients were prescribed cardioprotective therapy, and the control group (n=48), which consisted of patients who refused or had contraindications to cardioprotection. All patients underwent an examination, including the collection of complaints and anamnesis, physical examination, electrocardiography and echocardiography with an assessment of left ventricular (LV) global longitudinal strain before chemotherapy and 1, 3, 6, 9 and 12 months after initiation of anticancer therapy.Results. In patients of the control group, by the end of the follow-up, the left atrial volume index and LV end-diastolic volume index significantly increased. In the main group, these indicators did not change significantly. In the control group, by the final visit, the LV ejection fraction significantly decreased in comparison with the initial value and the value in the first group. After 6, 9 and 12 months, there was a significant decrease in the LV global longitudinal strain in the control group, while in the main group this indicator remained within the normal range. The mortality rate in the control group was significantly higher (15% vs 2% in the experimental group). In the experimental group, cardiotoxic complications occurred in 28%, while in the control group — in 78% of patients.Conclusion. The study demonstrated the significant importance of cardiac monitoring and primary drug prevention of cardiotoxicity of anticancer therapy. A sig nificant deterioration in LV systolic function was shown in patients with a high and very high risk of cardiotoxicity who did not receive cardioprotective therapy, while its high efficiency was demonstrated in patients of the experimental group.

Coronary artery disease (CAD) can manifest as a classic chest pain, or atypical angina. At the same time, the prevalence of CAD in a group of male patients with atypical angina over the age of 60 can reach 59--78%. It should be noted that the clinic manifestation of the chronic heart failure (CHF), which will be the main limiting factor, may take centre stage in diffuse coronary artery atherosclerosis. In patients with coronary artery disease and heart failure, who take atorvastatin, one should expect a decrease in the risk of adverse outcomes and hospitalizations due to heart failure. However, this does not negate the need for treatment and optimization of heart failure, if necessary. The therapy of these patients is based on the administration of high doses of angiotensin converting enzyme inhibitors (ACE inhibitors), beta-blockers (BB) and statins. The routine use of statins in heart failure with low ejection fraction (EF) is not recommended for the management of patients with heart failure from clinical guidelines point of view. This conclusion is based on two multicenter randomized clinical trials that have purposefully studied the use of statins in heart failure (CORONA and GISSI-HF). However, this document recommends the use of statins to prevent heart failure in patients with coronary artery disease. Continuing statin therapy in patients, who are already receiving these drugs for coronary artery disease or hyperlipidemia, should also be discussed. Thus, the use of atorvastatin in patients with coronary artery disease and systolic left ventricular myocardial dysfunction can reduce the risk of adverse outcomes and hospitalizations due to heart failure. In patients with non-ischemic heart failure, taking statins is not associated with improved survival. Thus, the decision to prescribe this group of drugs in patients with chronic heart failure should take into account the specific clinical situation and be strictly individualized.

Arterial hypertension remains the leading cause of death in the world and one of the global problems of the world healthcare.Left ventricular hypertrophy is a frequent complication of arterial hypertension, which in turn is a powerful independent predictor of morbidity and mortality. With a prolonged course of the disease, there are several models of remodeling the left ventricle. In this connection, this literature review presents diff erent points of view on the problem, as well as directions for further fundamental and practical research.

Objective – review current data on the use of beta-blockers (BB) in chronic heart failure (CHF).Materials and methods. This article discusses beneficial effects of BB administration in CHF patients. It has been demonstrated that decrease in heart rate underlies clinical efficacy of BB therapy in patients with chronic heart failure. We reviewed the question of the necessity to achieve target doses of BB in the treatment of CHF patients. It has been shown that administration of BB in patients with chronic heart failure and reduced left ventricular ejection fraction increase pumping function of heart, and thus reduce the number of hospitalizations for decompensated heart failure, reducing the risk of total and sudden mortality. We demonstrated substantial advantages of β1-selective BB over nonselective ones with respect to their impact on hemodynamics, metabolic processes, rheological parameters of blood and bronchi. We also considered therapeutic tactics in case of BB administration in CHF patients.Results. Based on the data of the current studies we proved high efficiency and safety of β1-selective BBs in CHF patients.Conclusion. Correct choice of BB in patients with CHF and decrease in heart rate during the treatment can significantly increase an effectiveness of the treatment.

Aim. To study the prognostic value of therapy-induced changes in plasma NT-proBNP levels in patients with left ventricular (LV) systolic dysfunction. Subjects and methods. The study covered 84 patients aged 23 to 70 years (mean 54±8.1 years) with LV systolic dysfunction (an ejection fraction of

An analysis of the results of surgical treatment of patients with aortic valve diseases and severe left ventricular systolic dysfunction (ejection fraction less than 35%) for the period from January 2005 to April 2011. The study included 39 patients who performed the aortic valve diseases correction. In order to improve the results of sur- gery was used developed a protocol that included preventive training in the intensive care unit with cardioto- nic drug levosimendan, the use of permanent methods of perioperative renal replacement therapy, using a hybrid approach with a combination of diseases with coronary artery disease. Hospital mortality was 5,1%. Based on these results it was concluded that the developed protocol can significantly improve the results of surgical treat- ment of patients with such severe category.

The study included 45 patients with coronary heart disease (CHD) and chronic heart failure (CHF) of functional class I-IV. Increased cardiac troponin T(cTnT) level could be used in verification and assessment of CHF decompensation severity. In CHF, increase in cTnT level was influenced by CHF decompensation, left ventricular systolic dysfunction and remodeling. At the same time, essential arterial hypertension, post-infarctial cardiosclerosis, permanent atrial fibrillation, left ventricular diastolic dysfunction, left atrium pathologic remodeling did not significantly influence cTnT concentration in patients with CHD and CHF.

То investigate effect of potassium chloride and its combination with actovegin infusions on cardiohemodynamics and CK, AsAT, myoglobine levels in AMI associated with left ventricular systolic dysfunction, two groups of patients were examined. Participants from the first group (n=26) received infusions of 1 % potassium chloride (4-6 g/d). In the second group, patients (n=23) received infusions of 1 % potassium chloride plus actovegin (0. 15-0. 3 mg/kg/h; 160-320mg/d). Comparative analysis of the data obtained revealed that, after infusion of potassium chloride plus actovegin (0. 15-0. 3 mg/kg/h), left ventriclar volumes reduced, IV contractility improved, BP and cardiac output increased, together with decrease in CVP, HR, DP (double product), and CK activity.