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Influence of therapy chronic heart failure of functional class III on regulatory adaptive status

Abstract

100 patients with CHF FC III against the background of ischemic heart disease (IHD) and/or stage III hypertensive disease (HD). All them administered of complex therapy (Quinapril, Torasemide, Spironolactone). Upon randomization, Group 1 consisted of 56 patients (57,5±21,7 years old) and received metoprolol succinate of sustained release (Betalok ZOK, Sweden's AstraZeneca, 59,1±12,7 mg per day). Group 2 consisted of 44 patients (57,1±21,4 years old) and received Ivabradine, inhibitor of If channels in the sinoatrial node (Coraxan, France's Servier, 12,1±4,6 mg per day) in cases when use of beta-blockers (BB) was not possible. VO2max treadmill tests, echocardiography, 24-hour blood pressure monitoring, NT-proBNP blood plasma test were done initially and 6 months in. A cardiorespiratory synchronism test was done in order to objectively evaluate the regulatory adaptive status (RAS). On the result of reseache, complex therapy with the use of Ivabradine showed comparable clinical effects with metoprolol succinate: improved the structural and functional condition of the myocard, increased tolerance to physical exercise, caused reduction in the level of NT-proBNP in blood plasma and increase of VO2мах during physical strain, but more than BB positively influenced the RAS. Therefore, Ivabradine can serve as an alternative to BB if it's impossible to use in patients with CHF FC III against the background of IHD and/or stage III HD.

About the Author

E. S. Rokotyanskaya
ГБОУ ВПО «Кубанский государственный медицинский университет» Минздрава России
Russian Federation


References

1. Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т. Хроническая сердечная недостаточность // Избранные лекции по кардиологии. - М.: ГЭОТАР-Медиа, 2006. - 432 с.

2. Гуревич М.А. Хроническая сердечная недостаточность: Руководство для врачей. - М.: изд.-во «Практическая медицина», - 2008. - 414 с.

3. Ерофеева С.Б., Манешина О.А., Белоусов Ю.Б. Место ивабрадина - первого If ингибитора избирательного и специфического действия, в лечении сердечно-сосудистых заболеваний // Качественная клиническая практика. - 2006. - № 1. - С. 10-22.

4. Мареев В.Ю., Агеев Ф.Т., Арутюнов Г.П. и соавт. Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (четвертый пересмотр) // Журнал «Сердечная недостаточность». - 2013. - № 7 (81). - С. 3-62.

5. Покровский В.М. Сердечно-дыхательный синхронизм в оценке регуляторно-адаптивных возможностей организма // Краснодар: «Кубань-Книга», 2010. - 244 с.

6. Покровский В.М. Формирование ритма сердца в организме человека и животных. - Краснодар, 2010. - 144 с.

7. Bristow M.R. Treatment of chronic heart failure with β-adrenergic receptor antagonists: A convergence of receptor pharmacology and clinical cardiology // Circ. res. - 2011. -Vol. 109. № 10. - Р. 1176-1194.

8. DiFrancesco D., Camm A. Heart rate lowering by specific and selective if current inhibition with ivabradin // Drugs. - 2004. -Vol. 64. № 16. - P. 1757-1765.

9. Dominguez-Rodriguez A., Blanco-Palacios G., Abreu-Gonzalez P. et al. Increased heart rate and atherosclerosis: potential implications of ivabradine therapy // World. j. cardiol. - 2011. - Vol. 3. № 4. - Р. 101-104.

10. Ekman I., Chassany O., Komajda M. et al. Heart rate reduction with ivabradine and health related quality of life in patients with chronic heart failure: results from the SHIFT study // Eur. heart j. - 2011. - Vol. 32. № 19. - P. 2395-2404.

11. Fang Y., Debunne M., Vercauteren M. et al. Heart rate reduction induced by the if current inhibitor ivabradine improves diastolic function and attenuates cardiac tissue hypoxia // J. cardiovasc. pharmacol. - 2012. - Vol. 59. № 3. - Р. 260-267.

12. Fox K., Ford I., Steg P.G. et al. оn the BEAUTIFUL Investigators. Heart rate as a prognostic risk factor in patients with coronary arteri disease and left-ventricular sistolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial // Lancet. - 2008. - № 372. - P. 817-821.

13. Gloekler S., Traupe T., Stoller M. et al. The effect of heart rate reduction by ivabradine on collateral function in patients with chronic stable coronary artery disease // Heart. - 2014. - Vol. 100. № 2. - Р. 160-166.

14. Heidenreich P.A., Albert N.M., Allen L.A. et al. Forecasting the impact of heart failure in the United States: a policy statement from the american heart association // Circ. heart. fail. - 2013. -Vol. 6. № 3. - P. 606-619.

15. McMurray J.J., Adamopoulos S., Anker S.D. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the european society of cardiology. Developed in collaboration with the Heart failure association (HFA) of the ESC // Eur. heart. j. - 2012. - Vol. 33. № 14. - P. 1787-1847.

16. Swedberg K., Komajda M., Böhm M. et al. SHIFT Investigators. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study // Lancet. - 2010. -№ 376. - Р. 875-885.

17. Tardif J.C., O’Meara Е., Komajda М. et al. Effects of selective heart rate reduction with ivabradine on left ventricular remodeling and function: results from the SHIFT echocardiography substudy // Eur. heart j. - 2011. - Vol. 32. № 20. - Р. 2507-2515.


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For citations:


Rokotyanskaya E.S. Influence of therapy chronic heart failure of functional class III on regulatory adaptive status. Kuban Scientific Medical Bulletin. 2014;(5):102-108. (In Russ.)

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ISSN 1608-6228 (Print)
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