Glyebova O. The role of endothelial dysfunction in progressing of chronic heart failure in patients with ischemic heart disease and postinfarction cardiosclerosis.

Dissertation is devoted to estimation of valueability of the types of cardiohemodynamics and endothelium function dysturbances at acute stage of myocardial infarction for postinfarction remodelling, the role of trimetazidine in correction of endothelial dysfunction and oxidative stress. In 112 patients with acute Q-miocardial infarction (AMI) it was set the increasing of levels of endotheline-1, NO metabolites, malonic dialdehyde, superoxiddysmutase, total prooxidant activity, that was parallel to the types of endotheline-1 activation, up-diffused by cluster analysis for high, middle and lower. In 3 month after AMI in patients with initial systolic dysfunction and in cluster group with high level of endotheline-1 endothelial dysfunction, oxidative stress tension remained, excentric hypertrophy of the left ventricle, its transfer to spherical form, and myocardial stress progressed, low ejection fraction remained. Trimetazidine included into standard therapy from 5th day of AMI leaded to more expressed decreasing of endotheline-1 and NO metabolites levels, renewal of oxidative-antioxidative balance, improvement of hemodynamics, life quality and increasing the tolerance to physical activity.