Kucherenko D. Arrhythmogenic atrial remodeling in patients with ischemic heart disease in a combination with diabetes mellitus.

The thesis is dedicated to improvement of diagnostics and treatment efficacy of ischemic heart disease in a combination with type 2 diabetes mellitus on the base of study of mechanisms of arrhythmogenic atrial remodeling development. Development of arrhythmogenic atrial remodeling in patients with ischemic heart disease in a combination with type 2 diabetes mellitus is accompanied by increased levels of atrial natriuretic peptide, angiotensin II, C-reactive protein. Structure functional changes in atria of patients are characterized by enlargement of their sizes, volumes, presence of left ventricular systolic and diastolic dysfunction. Prescription of ACE inhibitor ramipril decreases the activity of renin-angiotensin-aldosterone system, levels of atrial natriuretic peptide and C-reactive protein. The drug contributes to decrease structural remodeling and left ventricular systolic dysfunction. Usage of ?-3 polyunsaturated fatty acids is recommended first of all to patients with ischemic heart disease in a combination with type 2 diabetes mellitus, atrial fibrillation, hypertriglyceridemia, ventricular extrasystole. It is necessary to prescribe amiodaron to treat patients with persistent type of atrial fibrillation. Its combination with pathogenetic treatment by ramipril and ?-3 polyunsaturated fatty acids reduces arrhythmogenic atrial remodeling and helps to keep a sinus rhythm.