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Pulse decreasing therapy and parameters of central aortic pressure in patients with chronic heart failure of ischemic etiology

Temirsultanova T. Kh.

Keywords: CHF, central pressure

DOI: 10.18087/rhfj.2013.1.1790

Relevance. Assessment of vascular stiffness allows diagnosis of arterial lesions at the non-clinical stage, revealing of individuals with high cardiovascular risk. It is still questionable, how parameters of central aortic pressure (CAP) change in patients with CHD complicated by CHF during pulse decreasing therapy. Objective. Compare influence of two regimens of heart rate control therapy (beta-blocker bisoprolol vs. beta-blocker bisoprolol + If -channel inhibitor ivabradine) on CAP parameters in CHF patients. Materials and methods. 50 patients with CHF, angina FC I–III against post-infarction cardiosclerosis were examined. Results. Patient groups taking bisoprolol (n=25, mean CHF FC – 2.6±0.1, LVEF – 30.8±1.4 %) and combination of bisoprolol and ivabradine (n=25, CHF FC – 2.4±0.2, LVEF – 28.7±1.7 %) were compared. Results. Due to the therapy carried out, in Group 1, mean CHF FC went down to 2.2±0.1 in 3 months of treatment (15.6 %; р<0.001). In Group 2 mean CHF FC in 3 months of therapy went down to 2.1±0.2 (12.5 %; р<0.003). In 3 months, highly significant improvement of LV systolic function was observed in both groups: LVEF in Group 1 increased by 10.1 % from the baseline level and reached 33.7±1.2 % (р<0.005); in Group 2, LVEF increased to 33.8±2.1 % (15.1 %; р<0.0001). In group 2, appropriately greater pulse decrease was observed in 3 months of treatment, in comparison with Group 2. In bisoprolol group, CAP increased to 119.1±2.4 mm Hg, augmentation pressure (АР, mm Hg) increased from 9.9 [3.1;1 4.1] to 14.1 mm Hg [10.1; 17.1] in 3 months of therapy (р=0.05). In Group 2, dynamics of these parameters was analogous. Augmentation index (AIx, %) in Group 1 was 25.9 % [9.9; 30.9] at baseline and 33.5 % [24.7; 38.7] in 3 months of therapy (р<0.04). Similar situation was observed in Group 2. Buckberg index (SEVR,%) in Group 1 was at the average 165.1±5.7 % at the baseline, and 183.5±4.3 % in 3 months of treatment (р<0.0001). In Group 2, it was 178.1±6.1 %, in 3 months – 199.1±6.7 % (р<0.0001). Conclusion. Comparison of two regimens of heart rate control therapy in CHF patients showed not only greater decrease of pulse against the combination therapy, but also significantly more marked improvement of LV systolic function.
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Temirsultanova T. Kh. Pulse decreasing therapy and parameters of central aortic pressure in patients with chronic heart failure of ischemic etiology. Russian Heart Failure Journal. 2013;14 (1):47-52

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