Godlevska O. Structurally-functional remodeling a myocardium of a left ventricle of heart and a dispersion of interval QT at patients with a postmyocardial infarction cardiosclerosis and their correction

Object of research: postmyocardial infarction. Рurpose of the research – – increase of efficiency of diagnostics and ways of medicamentous correction of structurally functional and electrophysiological parameters of left ventricle of heart on the basis of studying of remodeling a myocardium left ventricle of heart, its systolic and diastolic functions, and also dispersions of interval QT and its parts at patients with postmyocardial infarction. Methods of research: general-clinical, laboratory, tool. The practical importanse of the received results consists that all patients with postmyocardial infarction are characterized by electrophysiological changes as increase in parameters of a dispersion of interval QT and its parts which correlate with parameters of systolic function of left ventricle of heart and indicate prognostic markers of fatal infringements of a rhythm and sudden intimate death. The dissertator proves expediency of use of the definition of a dispersion of interval JT, as a universal electrophysiological marker of systolic dysfunctions of left ventricle of heart at patients with postmyocardial infarction with normal geometry and at different types of its hypertrophy.Therapeutic efficiency of the combined reception of preparations of group ingibitor ACE and beta-blockers for more substantial improvement of structurally functional and electrophysiological properties of a myocardium of left ventricle of heart is determined. Scientific novelty of the received results. Structurally morphological changes of a myocardium of left ventricle of heart at patients with postmyocardial infarction in the early period are indicate by remodeling with preservation of normal geometry at 15 % of patients, a concentric hypertrophy more than at half of patients and excentric hypertrophy at third. The remodeling myocar-dium of left ventricle it is accompanied by early occurrence diastolic dysfunction of myocardium, which is most inherent for patients with a concentric hypertrophy and normal geometry of left ventricle. The formation of diastolic dysfunction creates conditions for occurrence and progressing of chronic intimate insufficiency. Excentric hypertrophy myocardium of left ventricle is accompanied by connection of systolic dysfunctions of myocardium which results in the further strengthening of heart failure manifestation and reduction of emission fraction. Structurally functional changes of myocardium of left ventricle are accompanied by infringement of repolariza-tion process in myocardium as increase in a dispersion of interval QT and its components, especially interval JT. The increase in a dispersion of interval QT and its parts directly correlates with structurally morphological parameters of myocardium of left ventricle: IMMlv, EDV and ESV, reduction of emission fraction and presence of infringements of a rhythm as ventricle extrasystole and fibrillation. Growth of a parameter of a dispersion interval QT is connected to occurrence remodeling myocardium of left ventricle as a concentric and excentric hypertrophy while change of composing part of interval QT - segment JT depends on a condition of systolic function of a myo-cardium irrespective of type of its geometrical model.Combined therapy enalapril and metoprolol intensify pharmacodynamic preparations efficiency which is indicate by reduction of dilatation of left ventricle, improvement of its systolic and diastolic functions, reduction of a dispersion of interval QT and all its composing parts, which confirm the success of such therapy.Degree of introduction: Results of researches are applied into practical work of І and ІІ therapeutic departments of City Clinical Hospital №26, a polyclinic and therapeutic department of Regional Student's Hospital №20, the Sumy Regional Hospital and cardiological department of sanatorium "Roscha". Sphere of application: medicine, therapy.