Biletskyi S. The state of the endothelial function, lipid peroxidation, vegetative provision of the cardiac performance in patients with unstable angina and acute myocardial infarction under the influence of adjuvant therapy with the use of metoprolol, carvedilol and melatonin

The dissertation deals with a study of the state of the endothelial function, peroxidation of lipids (POL) and proteins, heart rate variability, the structural-functional condition of the myocardium in patients with unstable angina and acute myocardial infarction (MI) and perfecting therapy by using carvedilol, metoprolol and melatonin. A positive correlation of a medium and high degree between the content of endothelin-1 [ET-1] and POL products has been revealed. It has been established that carvedilol causes a reliable decrease of the concentration of ET-1, POL products and proteins in patients with acute MI. It is indicative of the antioxidant and endothelium-protective properties of the medication. An advantage of carvedilol over metoprolol has been disclosed in the form of a reliable improvement of the parameters of intracardiac hemodynamics based on the results of a long-term follow-up (in a year) of patients who suffered from MI. It has been found out that an addition on of melatonin to the standard therapy acute MI results in a trustworthy increase of the activity of the parasympathetic component of the regulating effect of the vegetative nervous system on the heart