Zabida A. Endothelial dysfunction, systemic inflammation and end-products of glycation in patients with chronic heart failure in patients with post-infarction cardiosclerosis

The inclusion of L-Arginine in the complex treatment of patients with HFpEF with postinfarction cardiosclerosis led to the normalization of endothelial function (45% of patients) with an increase in the FMD% of 29.3 % (W = 0.3163, p = 0.003), GFR 14, 5 % (W = 0.603, p = 0.001); and a significant decrease in the levels of mmp-9 by 40.9 % (p < 0.05), AGEs by 15.3 % (p < 0.05) compared with the standard treatment group. The use of the combination of L-Arginine and L-Carnitine as part of the integrated treatment of patients with HFpEF with postinfarction cardiosclerosis led to a more significant normalization of endothelial function (67.5 %) in patients with an increase in FMD% by 31.9 % (W = 0.1873 , p = 0.005), GFR by 17.3 % (W = 0.306, p = 0.002), and a significant decrease in the levels of mmp-2 by 78.5 % (W = 0.202, p = 0.004), galectin-3 by 16, 4 % (W = 0.346, p = 0.001), AGEs by 19.6 %, (W = 0.294, p = 0.0002) compared with the standard treatment group. The data show expediency of the algorithm of examination of patients with HFpEF on the background of postinfarction cardiosclerosis determine the level galectin-3, mmp-9 as additional targets for monitoring and treatment, thereby increasing the efficiency of diagnosis of CHF with the aim of preventing progression of this disease in patients with postinfarction cardiosclerosis. The purpose of the combination of L-arginine and L-carnitine against the background of standard therapy improves the functional state of the endothelium, reduction of galletin-3, mmp-2, end-product glycation in patients with postinfarction CHF with preserved systolic function and renal dysfunction, therefore, may be recommended in this pts category.