Mordyashova S. Сlinical and genetic features and expediency of spironolactone in patients with hypertrophic cardiomyopathy

The thesis describes how to improve clinical and genetic aspects of investigation and studies expediency of aldosterone blockade in patients with hypertrophic cardiomyopathy. Factors which influence a clinical current of disease and expressivity of heart remodeling are defined: polymorphisms of aldosteron synthase gene (CYP11B2) in the Ukrainian population among patients with hypertrophic cardiomyopathy is studied for the first time. The influence of angiotensinconverting enzyme gene polymorphisms on clinical course of hypertrophic cardiomyopathy has been evaluated. It was established, that patients with apical form have a favorable character of a clinical course of hypertrophic cardiomyopathy. It is proved that heart remodeling and left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy associated with arrhythmias. The author established efficiency and safety of the six-minute walking test as a exercise stress test in patients with hypertrophic cardiomyopathy and factors which influence size of the passed distance were established. Optimal treatment of patients with hypertrophic cardiomyopathy has been achieved: positive dynamics of clinical features as a result of addition of spironolactone to basic therapy has been proved.