Latoguz S. Pathogenetic mechanisms and therapeutic aspects of endothelium dysfunction at arrhythmia in patients with ischemic heart disease with an accompanying pathology.

Object of the study: Patients with CCAD, DMII, CNLD with rhythm disorders. Purpose of the study: Optimizing the diagnosis of endothelium dysfunction and improvement of the methods of treatment in arrhythmia in patients with CCAD, DMII, CNLD. Methods of research: Clinical methods of examination, determining lipid spectrum of the blood, blood coagulation, endothelin-1 level, prostacyclin, cGMP, thromboxane, blood glucose, indices of renin-angiotensin-aldosterone system, electrolyte concentration, measuring AP, ECG, tetrapolar rheography, veloergometry, echocardiography, circadian monitoring of the BP and ECG. Theoretical and practical results: It was shown that in patients CCAD and DMII with accompanying arrhythmias administration of ACE inhibitor, perindopril, is accompanied by improvement of the endothelium function as well as a positive shift of blood circulation parameters, reduction of the left ventricle myocardium dysfunction. The necessity of perindopril in CCAD with DMII and an accompanying arrhythmia was substantiated. The peculiarities of the disorders of renin-angiotensin-aldosterone systems in CCAD with DMII were determined. The significance of treatment with ACE inhibitors of prolonged action was shown. Administration of carvedilol to the patients with CCAD and DMII with accompanying arrhythmias is ac-companied by improvement of endothelial function, reduction of the blood pressure and positive changes in the blood circulation. Novelty: It was shown that in patients with CCAD and DMII with accompanying arrhythmias (ventricular extrasystole and ciliary arrhythmia), increased concentration of plasma endothelin-1 and Tx2 levels is observed, which suggests the advantages of vasculoconstrictive effects. For the first time, the data that in patients with CCAD and DMII with accompanying arrhythmias, administration of perindopril promotes reduction of the number of ventricular extrasystoles. For the first time, it was shown that combined therapy with anti-arrhythmic drugs and AUVBI in patients with CCADand DMII with accompanying ventricular extrasystole is accompanied by more considerable anti-arrhythmic effect when compared with monotherapy with one of the above drugs separately. Degree of introduction: The findings of the research are used in the work of hospitals of Kharkiv and RCH of Kharkiv, City Clinical Hospitals No. 1 and 2 (Kharkiv), Institute of therapy AMS of Ukraine (Kharkiv), therapy and cardiology departments of hospitals of Lugansk, Poltava regions. The findings of the re-search are used in the teaching process at department of internal diseases, physical therapy and sport medicine of Kharkiv State Medical University and in the lectures for doctors and interns of RCH of Southern Railroad.. Sphere of application: Medicine, therapy.