Dissertation is devoted to the optimization of diagnosis and treatment of immune-inflammatory disorders and profibrotic dysfunctions which are based on elucidate the role of interleukin-1?, interleukin-10 and monocyte chemoattractant protein-1, matrix metalloproteinase-9, in the progression of chronic heart failure in patients with coronary heart disease and type 2 diabetes. The study involved 105 patients with chronic heart failure with ischemic heart disease. The main group included 60 patients with coronary artery disease and heart failure with type 2 diabetes, and the comparison group consisted of 45 patients without type 2 diabetes. The control group consisted of 10 healthy people. Received data about the progression of chronic heart failure with decreasing glomerular filtration rate less than 59ml/min accompanied by an imbalance of system fibrosis-fibrolysis with high activity of fibrotic parameter - monocyte chemoattractant protein-1 and a decrease of antifibrotic matrix metalloproteinase-9 to 11,62%, in violation of renal function by increasing the level of ?2-microglobulin on 38,46%. Increasing of signs of cardiac decompensation was associated with increased pro-inflammatory interleukin-1? on 23,7% and a decreased anti-inflammatory interleukin-10 on 37%. It indicates about a disadaptive response of units of cytokines in patients with coronary heart disease and type 2 diabetes mellitus, and in patients without type 2 diabetes - a high activity of pro - and anti-inflammatory cytokines level system. The presence of chronic heart failure in patients with coronary heart disease and type 2 diabetes mellitus when glomerular filtration rate more than 60m/min associated with the prevalence of concentric left ventricular hypertrophy, and glomerular filtration rate less than 59 ml/min - eccentric type due to excessive activity of a marker of fibrosis monocyte chemoattractant protein-1 in the absence of adaptation mechanisms of deterrence fibrolysis matrix metalloproteinase-9, a violation of lipid metabolism of atherogenic character. Using nebivolol and carvedilol as part of standard therapy in patients with coronary heart disease and type 2 diabetes mellitus accompanied by positive dynamics of renal function, decreased activity of interleukin-1? on 9,8% and 10,5%, fibrosis by activity reducing monocyte chemoattractant protein-1 on 7,8% and 10,1%, glomerular renal function by increasing the glomerular filtration rate on 4,6% and 5,9%, tubular function by reducing urinary albumin on 6,1% and 8,8%, and the decrease of percentage of patients with eccentric left ventricular hypertrophy on 6% and 9%, respectively, with no adverse impact on the parameters of lipid and carbohydrate metabolism, which is more clearly revealed in the appointment of carvedilol.
