Khaled N. Immunoinflammatory aspects of chronic heart failure

3. The research object was patients with chronic heart failure (CHF) caused by ischemic heart disease and dilated cardiomyopathy. The aim was to improve the efficacy of the CHF treatment on the basis of the research of pro- and anti-inflammatory cytokines in patients with heart failure due to different etiology and study of possibilities and clinical-pathogenetic significance of therapeutic correction of their activity. Research methods and equipment: enzymoimmunoassay, enzymatic assay (multichannel microphotometer "Multiscan" ("Flow")), physical examination of patients, X-ray-television (X-ray apparatus "EDR-750 VS with URY"), electrocardiography (electrocardiograph "Fukuda" FX-326U), Holter ECG monitoring (Holter ECG monitor "Kontron instruments"); exercise test, (bycicleergometer "V 380"), quantitative echocardiography (apparatus "TI228A" ("RADMIR"). Theoretical novelty - it was first revealed that the increase of pro-inflammatory cytokines activity in patients with CHF was accompanied by considerable growth of the levels of anti-inflammatory cytokine interleukin-4, which is closely associated with the progression of left ventricular systolic dysfunction; it was shown that the increase of the pro-inflammatory cytokines serum activity more late event in CHF development and progression, than neurohumoral activation; it was established that the distinguishing feature of dilated cardiomyopathy is the elevation of interleukin-6 levels; the mechanisms of positive action of angiotensin-converting enzyme (ACE) inhibitors in CHF were specified and it was shown that the ability to diminish cytokines activity is one of the pathogenetically significant factors determining their efficiency. Practical novelty - the value of pro-inflammatory cytokines investigation in patients with CHF for estimation of severity of disease and for objective estimation of efficiency of the therapy by ACE inhibitors and achievements of plenitude of their therapeutic effect was shown; the expedience of the correction of inflammatory activity in CHF patients for the increase of efficiency of treatment and prevention of CHF progression was proved; it was shown, that the one of the remedy of correction of excess cytokines production in CHF can be ACE inhibitors, but for the receipt of significant anty-cytokine effect their administration in maximally close to target in CHF doses is necessary. Degree of introduction: the results were introduced into the work of the clinics of Kharkov, Kiev, Vinnitsa. Field of application: cardiology, therapy.