2012


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2012/№2

Efficiency of the administration of nitrates in patients with chronic heart failure of the ischemic genesis combined with chronic obstructive pulmonary disease

Evdokimova A. G., Kovalenko E. V., Evdokimov V. V.

Keywords: treatment, nitrates, chronic obstructive pulmonary disease, CHF

DOI: 10.18087/rhfj.2012.2.1641

Relevance. Combination of CHD and chronic obstructive pulmonary disease (COPD) occurs in more than 62 % patients of older age groups. CHF is the most frequent complication of such states. Objective. Study clinical efficacy of isosorbide 5 mononitrate (Monocinique) in patients with stable exertional angina in combination with COPD. Materials and methods. 67 patients aged 50–75 years with CHF against postinfarction cardiosclerosis, II–III FC stable angina and COPD were studied. Patients of the 1st group took isosorbide 5 mononitrate, the 2nd group – isosorbide dinitrate. Quality of life dynamics, exercise tolerance, indices of painless myocardial ischemia, central hemodynamics and remodeling processes were studied by EchoCG data. Results. In 4 months of monitoring, number of heart stroke cases and sublingual nitroglycerin requirement per week reduced in the 1st group by 64 % and 72 %, and in the 2nd groups – by 54 % and 58 %, relatively. The 1st group had significant decrease of number and duration of painless myocardial ischemia episodes by 57.8 % and 60.4 % relatively. The 2nd group had 24.5 % and 23.8 % reduction, relatively. Administration of isosorbide 5 mononitrate resulted in reduced LV and RV dimensions, myocardial mass index (MMI), improved LV systolic function, reduced average pulmonary arterial pressure, improved respiratory f unction (RF). Conclusion. Introduction of isosorbide 5 mononitrate to the combined therapy of II–III FC angina with concomitant COPD and complicated CHF contributes to good clinical state, reduced painless myocardial ischemia indices, better angina FC, CHF and RF.
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Evdokimova A. G., Kovalenko E. V., Evdokimov V. V. Efficiency of the administration of nitrates in patients with chronic heart failure of the ischemic genesis combined with chronic obstructive pulmonary disease. Russian Heart Failure Journal. 2012;13(2):83-86

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