Zemlyanyy Y. Improving the diagnosis, treatment and prognosis of chronic heart failure with preserved ejection fraction in patients after Q-myocardial infarction

This dissertation deals with increasing efficiency of diagnosis,treatment and prognosis of heart failure with preserved left ventricular ejection fraction in patients after myocardial infarction on the background of hypertension by clinical characteristics of the disease, structural and functional state of the heart,level of GDF 15 in serum and destination of drugs affecting the renin-angiotensin-aldosterone system. To this end, examined 155 patients with this pathology. It was established that the formation of heart failure with preserved ejection fraction and diastolic asymptomatic left ventricular dysfunction in patients after myocardial infarction on the background of hypertension accompanied by increased levels of GDF 15 in serum. It is proved that in these patients occurs mainly concentric hypertrophy and diastolic dysfunction by type of infringement relaxation with increased left atrial volume index and the E/E' ratio. It is shown that in patients with heart failure with preserved ejection fraction independent predictors of adverse cardiovascular events are the level of GDF 15 in serum, ejection fraction, left ventricular mass index, E/E' ratio and in patients with asymptomatic diastolic dysfunction the only independent predictor is the level of GDF 15 in serum. Specified scientific data on the prevalence of positive effects of candesartan on left ventricular diastolic function, the level of NTproBNP and exercise tolerance compared with ramipril.