Svintozel'skiy A. Peculiarities of chronic heart failure course and treatment in aged and geriatric patients

Thesis is devoted to the study of peculiarities of cardiohaemodynamics, functional myocardium reserve, vegetative nervous system state, cerebral natriuretic peptide concentration, life quality ratings and grounding of principles of use and dosing of selective beta-adrenergic blocking agents in combined therapy of heart failure caused by coronary heart disease in aged and geriatric patients. It was revealed that aged and geriatric patients with chronic heart failure (CHF) have disturbances of structure functional state of left ventricle, cardiac rate variability, clinical state and life quality, cerebral natriuretic peptide production increase. It was revealed that life quality of CHF patients most of all is associated with patient's psychosomatic features, his age and closely correlates with intensity of clinical manifestation of disease, cardiohaemodynamic features, vegetative nervous system state and level of cerebral natriuretic peptide. Titration regimen of selective beta-adrenergic blocking agents metoprolol and bisoprolol were worked out for the treatment of such patients. Direct comparative investigation of cardial effects of metoprolol and bisoprolol in combined therapy of heart failure in aged and geriatric patients was performed. Proposed treatment regimen with metoprolol and bisoprolol improves life quality in such patients more effective than conventional treatment. It was proved that combined therapy with beta-adrenergic blocking agents does not cause worsening of treatment tolerance in aged and geriatric patients, does not provoke unexpected serious side effects and it is harmless.