Vlasenko O. Pathogenetic and clinical aspects of regenerative treatment of patients with postinfarction car-diosclerosis at a sanatorium stage.

Object of the study: Remodeling of the left ventricle myocardium in patients with postinfarction cardiosclerosis at a sanatorium stage of restoration treatment. Purpose of the study: To improve the principles of restorative treatment in patients with postinfarction cardiosclerosis based on the study of structural functional peculiarities of myocardium remodeling and the state of neurohumoral systems and their interrelation with the character of chronic heart failure as well as development of the methods of correction of these changes. Methods of research: General clinical, instrumental, bio-chemical research. Theoretical and practical results: Introduction of the findings of the research allows to increase the diagnostic capabilities of restorative treatment, improve its efficacy and quality of life of the patients. It was suggested to determine disorders of diastolic heart failure with the use of the indices of relaxation and contractile function with the purpose of diagnosis and investigation of CHFdevelopment. Diagnostic reasonability of and therapeutic necessity of general assessment of functional contractile capabilities of the left ventricle myocardium in determining the degree and character of myocardium hypertrophy and disorders of diastolic function were proven. It was recom-mended to use beta-adrenoblockers in patients with concentric hypertrophy and relaxation disorders with the purpose to improve hemodynamic capabilities of the myocardium. It was established that the most effective method of CHF correction in excentric hypertrophy was the use of blockers of beta-adrenergic receptors with vasodilating properties. Novelty: For the first time, significance of LV remodeling capabilities which was observed in 80.3% of cases, of them 55.6% - concentric hypertrophy, 24.7% - concentric hypertrophy, as well as its association with activity of cardiac hormone level (noradrenalin, aldosterone, brain natriuretic peptide in the peripheral blood, were established. It was shown that an important role in LVmyocardium remodeling is played by activation of neurohumoral indicators of sympatho-adrenal and renin-angiotensin-aldosterone systems (noradrenalin, aldosterone, brain natriuretic peptide) and directly correlates with the degree of myocardium hypertrophy as well as CHF severity. Degree of introduction: The findings of the research were introduced into the work of cardiology department of Roscha sanatorium, out-patient and therapy department of hospital No. 20, therapy and cardiology department of Sumy and Poltava regional hospitals. Sphere of application: medicine, therapy.