Object of the study: Chronic heart failure due to coronary artery disease. Purpose of the study: To improve the diagnosis and treatment of CSD with CHF basing on the study of the state and role of pro- and anti-inflammatory mechanisms (SRP, TNF-?, IL-1?, IL-6, IL-10) in the progress of CHF and influence on their level of drugs (ACEI enalapril maleate and ?-adrenoblocker metoprolol tartrate. Methods of research: General clinical, laboratory, instrumental, statistical methods. Theoretical and practical results: The necessity to determine the levels of pro- and antiinflammatory CK, RCTL, CD3+, PN, ІgА in patients with CHF with the purpose to improve the quality of diagnosis was substantiated. The study of the changes in the concentration of SRP, TNF-?, IL-1?, IL-6, IL-10 allows to improve the assessment of CHF severity and early diagnosis of the disease progress. Determining IL-1? level allows to improve the diagnosis of concentric and excentric LV myocardium hy-pertrophy in patients with postinfarction cardiosclerosis with CHF. Determining immunity parameters in CHF allows to control the state of the immune system under the influence of the treatment and to choose the treatment protocol in CAD. Combination therapy with ?-adrenoblockers and ACEI positively influences the immune indices and promotes improvement of the treatment efficacy and reduction of the treatment duration as well as complication prevention in CAD. Novelty: CHF due to CAD, postinfarction cardiosclerosis was shown to be accompanied by the changes in cellular and humoral mechanisms of the immunity in combination with activation of the cytokine link, manifestation of which is associated with structural functional changes in the LV myocardium and CHF severity. Main mechanism of CHF development on the initial stages (FC I-II) was determined to be impairment of diastolic function of the LV myocardium due to the presence of concentric myocardium hypertrophy. It was established that the presence of concentric and excentric LV myocardium hyper-trophy in postinfarction cardiosclerosis with CHF directly cor-related with the increase of anti-inflammatory CK IL-1? level, which was proved with the presence of positive correlation with LV MMI and RTI. Correction of immune-inflammatory disorders in CHF is achieve by administration of ACEI enalapril maleate and ?-adrenoblocker metoprolol tartrate and to be accompanied by re-duction of anti-inflammatory CK and SRP levels, elevation of IL-10 level, restoration of the morphofunctional parameters and diastolic function of the LV myocardium, as well as improve-ment of CHF manifestations. Treatment with ?-adrenoblockers and ACEI, especially their combination, results in possible re-duction in blood TNF-?, IL-1?, SRP, diminishing LA size and LV volume, E/A indices increase. Degree of introduction: The findings of the research were in-troduced into the work of city hospital No. 20, general practitio-ner office "Internationalist", cardiology department of sanatorium "Roscha". A method of diagnosis of CHF progress in postinfarc-tion cardiosclerosis using the findings of determining blood se-rum TNF-?, IL-1? and IL-6 was worked out, a patent № 67577, UA, 7, G01N33/48 dated 15.06.2004 "A method of diagnosis of chronic heart failure progress after myocardial infarction" was obtained. Sphere of application: medicine, cardiology.
