EFFECTIVENESS OF PHARMACOTHERAPY FOR NORMALIZATION OF THE BRAIN NATRIURETIC PEPTIDE, RENINE-ANGIOTENSINALDOSTERONE SYSTEM ACTIVATION AFTER SURGICAL REVASCULARIZATION OF MYOCARDIUM IN POSTINFARCTION CARDIOSCLEROSIS PATIENTS
Aim. The research on medical technologies for optimization of complication prevention and of post-surgery management of patients with coronary heart disease (CHD) with ejection fraction (EF) of the left ventricle (LV) <40% in surgical revascularization of the heart. Material and met...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
«SILICEA-POLIGRAF» LLC
2016-12-01
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| Series: | Кардиоваскулярная терапия и профилактика |
| Subjects: | |
| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/514 |
| Summary: | Aim. The research on medical technologies for optimization of complication prevention and of post-surgery management of patients with coronary heart disease (CHD) with ejection fraction (EF) of the left ventricle (LV) <40% in surgical revascularization of the heart. Material and methods. In the controlled, randomized study of 103 CHD patients with severe systolic dysfunction of the LV, the effectiveness of aortic coronary bypass surgery was studied. All patients underwent clinical investigations, where the severity of patient’s condition was assessed, as the risks of surgery by EuroSCORE, severity of heart failure signs by the clinical condition scale, echocardiography, clinical and chemistry lab. Aldosterone levels were studied with immune enzyme assay, brain natriuretic peptide — with immune enzyme assay, redox potential (NAD/NADP) with the Sigma-Aldrich system, procollagen III of N-end peptide — with the test-system USCN, Statistics was done on the software Statistica 8.0.Results. The inclusion to pre-operation preparing of patients of a drug with positive inotropic properties and decreasing the level of systemic inflammation syndrome, dosage of 2 ampules intravenously during 3 days before operation and with following 7-day post-surgery, in CHD patients with significant LV dysfunction influences positively the symptoms of chronic heart failure, initiates the deremodeling of the heart — significantly decreases the end-systolic size and increases EF LV, reduces pulmonary hypertension, significantly decreases the duration of artificial ventilation, timing of inotropic support, duration of stay in ICU. It is shown that the level of brain natriuretic peptide (NT-proBNP) in plasma does negatively correlate with EF LV (r=-0,69, p<0,01) and redox-potential NAD/NADP (r=-0,89; p=0,0001). At the background of Adenotsin® treatment there is significant decrease of NT-proBNP level by the 7th day after operation by 55%, the level of renin decreases, of aldosterone and procollagen type III in blood, that confirms the positive prognosis of treatment. There are no negative events in the drug course of implication for the studied category of patients.Conclusion. The data obtained makes it to recommend Adenotsin® for presurgery medication and postsurgery therapy in cardiovascular diseases. |
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| ISSN: | 1728-8800 2619-0125 |