Nagorna V. Clinical, hemodynamic and neurohumoral aspects of chronic heart failure diagnostics and treatment in patients with ischemic heart disease and type 2 diabetes mellitus.

Dissertation research is dedicated to study pathogenetic mechanisms of chronic heart failure in people with ischemic heart disease and type 2 diabetes mellitus, improvement the diagnostics and treatment. It is found that chronic heart failure progress in patients with carbohydrate disorders is accompanied with increasing brain natriuretic peptide level, raising angiotensin II and endothelin-1 levels. Prescription of perindopril ACE inhibitor provides decrease the activity of renin-angiotensin-aldosterone system and endothelin-1 level without side effects on carbohydrate and lipide parameters. It is important to note the presented positive clinical performances due to prescription of trimetazidin which together with evident antianginal effect helps to reduce brain natriuretic peptide and endothelin-1. It has been presented that sustained amiodarone usage for patients with chronic heart failure induced by ischemic heart disease and type 2 diabetes mellitus helped to reduce atrial fibrillation paroxysm frequency and sinoatrial rate; it is also provided an antianginal effect. Evident spontaneous thrombocyte aggregation reduction, thrombocyte aggregation time reduction and thrombocyte disaggregation increasing have been noted during the clopidogrel treatment in patients with chronic heart failure induced by ischemic heart disease and type 2 diabetes mellitus. Prescribing of clopidogrel is the alternative of others antiplatelet drugs in such group of patients.