The dissertation presents a new solution of the actual scientific and practical task of modern cardiology - justification of expediency and processing indications for revascularization interventions in patients with ischemic heart disease (IHD) and preserved left ventricular ejection fraction (LVEF)on the basis of the study of objective criteria for assessing their effectiveness and study of indicators the quality of life before and after coronary revascularization. The study patients with coronary heart disease and preserved LVEF were sequentially selected and divided into groups of CABG (n = 71) and stenting of coronary arteries (n = 44). As a control group we took patients with coronary artery disease with reduced LVEF (LVEF <45%, n = 148). A group of patients with (IHD) and preserved LVEF was characterized by a greater proportion of women (23.4 vs. 12.2%), patients with peripheral vascular disease (63.8 vs. 27.0%). In the group with systolic dysfunction dominated men (p=0,022), more often with previous myocardial infarction, including secondary MI (p <0,001), and HF II B stage by Strazhesko-Vasilenko classification (p = 0.001). At the same time, according to the coronary angiography, the groups of patients with and without systolic dysfunction of LV had no differences in the number of affected coronary arteries. The scales of QoL in SF-36 and SAQ questionnaires in the group of patients with (IHD) and preserved LV EF were no less pronounced than in patients with reduced LV EF. The choice between CABG or PCI in patients with (IHD) with preserved LV EF depended most on the anatomical features of the coronary lesion. According to the coronary angiography, in the CABG group, hemodynamically significant lesions of the left main coronary artery were observed more often, as well as three-vessel disease without hemodynamically significant lesions of proximal LAD. Also, in the CABG group, stenosis of the proximal LAD was more pronounced, while in the stenting group one-vessel disease were more frequently observed. In addition to the anatomical features that favored some kind of revascularization, the important differences between the study groups were the more pronounced angina pectoris (III CCS) and heart failure in patients selected for CABG. After 6 months of follow-up, patients with stable (IHD) and preserved LV EF after PCI and CABG showed a significant improvement in QOL scores compared to baseline data from questionnaires MLHFQ, SF-36 and SAQ. In the CABG group, the most significant improvement in QOL in all scales was observed during the first 6 months, and with further follow-up (from 6 to 12 months), the improvement of the QOL was maintained only with MLHFQ questionnaire and the individual subscales of the SF-36 questionnaire. The beneficial dynamics of the QOL may be due to the improvement of the myocardial diastolic dysfunction and heart failure, reflected by a significant decrease of the brain natriuretic peptide, increase of the 6 minutes walking test distance, as well as favorable changes of the individual Doppler echocardiographic indicators of the diastolic function during 6 months follow-up.
