Dykukha I. The role of extracardiac factors in genesis of arrhythmias and their pharmacological correction in ischaemic heart disease patients with initial coronary atherosclerosis

The dissertation is investigating the problem of arrhythmia pathogenesis in patients with coronary heart disease with initial coronary atherosclerosis. Based on studying of autonomic nervous system tonus, phospholipid and fatty acids metabolism in myocardial cells and erythrocytes membranes in patients with coronary heart disease with initial coronary atherosclerosis the connection between arrhythmias and both cardiac (myocardial ischemia) and extracardiac (autonomic dysfunctions and lipid metabolism disorders) factors was found. It was shown that arrhythmias in patients with coronary heart disease with initial coronary atherosclerosis do not depend on localization of one-vessel burden, but frequency and severity of arrhythmias increase in accordance to increasing of number of impacted coronary vessels. Deep fatty acids b-oxidation disorders in cardiomyocytes were found. Correlation connections were established between peculiar arrhythmias and fatty acids metabolism disorders in myocardiocytes and erythrocytes membranes. The rationale for treatment of coronary heart disease at initial coronary atherosclerosis stages with b-blockers was studied. It was proved that combined ?1,b1,2-blocker carvedilol was preferable in treatment of coronary heart disease patients with initial coronary atherosclerosis.