Muzyka N. Endothelial dysfunction and remodeling of left ventricle in patients with heart failure in patients with coronary artery disease and the effectiveness of different methods of treatment.

The dissertation is devoted to the problem of the management of patients with CHF of ischemic genesis with different magnitude of FE LV (153 persons were examined). The following changes in echocardiographic parameters were found among patients with CHF of ischemic genesis with reduced FE LV when comparing with patients with CHF of ischemic genesis with preserved FE LV: a significant increase in left atrium size by 13.5 %, index end-systolic size - by 116.0 %, left ventricular myocardial mass index - by 51.3 % (p<0.01) and a significant reduction of FE LV by 36.8 % (p<0.01). It was established that in the examined patients with CHF with reduced FE LV compared with healthy people, a significant reduction of the eNOS index by 96.77 % was determined, including the level of serum eNOS (371.9 ± 29.30) pg/ml, whereas in healthy subjects (control group) (731.8 ± 84.63) pg/ml (p<0.01). The conducted study allowed to establish that in patients with CHF of ischemic genesis, the level of eNOS in blood serum less than 401.20 pg/ml can be considered as boundary - that is associated with a decrease in FE LV ≤ 45.0 %, which should be used as a criterion for deterioration of intracardiac parameters hemodynamics and CHF progression. Assignment of patients with CHF of ischemic genesis with reduced and preserved FE LV standard complex therapy with additional application of L-arginine hydrochloride increases the effectiveness of treatment. Key words: stable ischemic heart disease, heart failure, endothelial nitric oxide synthase, cardiac remodeling. Branch - Medicine.