Russian Heart Failure Journal 2005year Effects of combination therapies on clinical presentation, hemodynamics and morpho-functional parameters of the heart in patients with chronic heart failure


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2005/

Effects of combination therapies on clinical presentation, hemodynamics and morpho-functional parameters of the heart in patients with chronic heart failure

Olbinskaya L.I., Sizova Zh.M

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Urgency. Despite the great variety of drugs for treatment of CHF rational pharmacotherapy is not always applied in a proper way, especially in using combination therapies. Aim. Evaluating the effects of current combined pathogenetic therapies on clinical manifestations of disease, hemodynamics, morpho-functional parameters of the heart and exercise tolerance in patients with II–IV NYHA FC CHF having complicated the course of IHD. Material and methods. Study was performed on 355 patients aged from 43 to 76 years with II–IV NYHA FC CHF and left ventricular ejection fraction (LV EF) <45% having complicated the course of IHD. Evaluation of combination therapy efficacy and safety included dynamics of clinical manifestations of disease, hemodynamic parameters, cardiac bioelectric activity and rhythmic performance; dynamics of morpho-functional cardiac parameters; analysis of laboratory data. Results. Pharmacotherapy of II–IV FC CHF having complicated the course of IHD should be a combination treatment. The most efficient one was the ACEI, diuretics and β-adrenoblocker combination which decreased the CHF FC by 16.4% (р<0.05), LV end-diastolic (EDV) and end-systolic volumes (ESV) – by 12.2 and 16% respectively, and increased the LV EF by 16.9%. Combination drug therapy of II–IV FC CHF with exacerbation of angina should be supplemented with nitrates which have demonstrated good efficacy in II–III FC angina in 59.2% of patients and satisfactory efficacy in 40.8% of patients.

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