Object of the research: metabolic syndrome (MS) in patients with chronic coronary disease (CD) and cardiac rhythm distur-bances. Purpose of the research: optimization of the diagnosis and treatment of cardiac rhythm disturbances in patients with MS. Methods of the research: in order to solve the set tasks, clinical methods of examination of patients were used, as well as the blood lipid spectrum, levels of cyclic guanosine monophosphate (cGMP), blood glucose, immunoreactive insulin, indices of the renin-angiotensin-aldosterone system, the level of electrolytes were determined, blood pressure was taken with help of Korotkov’s method, electrocardiogram (ECG) was recorded, tetrapolar chest rheography, veloergometry, ECG daily monitoring and heart ultrasonography were made. Theoretical and practical results: administration of Lovastatin, a drug preparation from the group of statins, to patients with MS accompanied by arrhythmiae both facilitates the development of the hypolipidaemic action and contributesto reduction in the number of supraventricular and ventricular extrasystoles. In full measure, the necessity of administering Ramipril to patients with MS accompanied by arrhythmiae was grounded, therewith facili-tating both the improvement of cardiohaemodynamic indices and the reduction in the number of extrasystoles and paroxysms of ventricular fibrillations. Peculiarities in the disturbances of the renin-angiotensin-aldosterone system in patients with MS accom-panied by heart rhythm disturbances were determined, the signifi-cance and necessity of giving the treatment with Ramipril, an an-giotensin-converting enzyme (ACE) long-action inhibitor were shown. Treatment of patients with MS accompanied by heart rhythm disturbances with help of Carvedilol was approbated and introduced into practice. It was shown that the drug preparation improved the cardiohaemodynamic indices, reduced the rate of ventricular extrasystole, did not produce any negative effect on the lipid and carbohydrate metabolisms. The importanceand ne-cessity of administering Amiodarone to patients with MS, when they developed the paroxysmal or persisting form of cardiac fibril-lation, was demonstrated. The drug preparation facilitated the res-toration and maintenance of the sinus rhythm and produced little effect on the carbohydrate and lipid metabolisms. Novelty: for the first time, the research produced the data that pa-tients with MS and arrhythmia (ventricular extrasystole, cardiac fibrillation) revealed a higher blood plasma concentration of en-dothelin-1, angiotensin II, this fact being important evidence of the prevalence of vasoconstrictive effects of the vasoregulatory systems. There was a further development of the proposition that the treatment of MS patients with Lovastatin was accompanied by positive changes in the blood lipid spectrum, a lower manifesta-tion rate of coronary insufficiency, as well as a reduced number of supraventricular and ventricular extrasystoles. For the first time, it was shown that the treatment of MS patientswith Ramipril, an ACE inhibitor, was accompanied by a lower rate of paroxysms in cardiac fibrillation and a reduced number of extrasystoles rather than by an improvement in cardiohaemodynamic indices only. For the first time, it was demonstrated that the treatment of MS pa-tients with Carvedilol was accompanied by significant antiar-rhythmic and antianginal effects. A lower number of ventricular extrasystoles took place against a background of a reduced activ-ity of the renin-angiotensin-aldosterone system, a higher level of cGMP and decrease of endothelin-1. There was a further devel-opment of the proposition that the administration of Amiodaron to patients with paroxysmal and persisting forms of cardiac fibrilla-tion contributed to the restoration and stabilization of the sinus rhythm. Degree of introduction: results of the research were introduced into the work of medical establishments of the City of Kharkiv and the Region: Kharkiv Railway Station Hospital, Kharkiv City Clinical Hospital No. 17, Kharkiv City Polyclinic No. 18, Kharkiv Regional Traumatology Hospital, Cardiological Department of Chernivtsi City Clinical Hospital No. 3, as it is confirmed by acys on introduction. Materials of the research were introduced and are used in the pedagogical process at the Department of Internal Medicine and Occupational Diseases of Kharkiv National Medical University of the Ministry of Health of Ukraine, in lectures for doctors, interns of the Kharkiv Railway Station Hospital Sphere of application: medicine, cardiology departments.
