Ilikchiieva N. Differentiated approach to the use of vasoactive drugs for ischemic heart disease combined with arterial and pulmonary hypertension

The dissertation presents new approaches to solving the actual problem of cardiology, which is to increase the effectiveness of treatment of patients with ischemic heart disease in combination with arterial hypertension and pulmonary hypertension (PH) complicated by heart failure (HF) IIA and IIB stages by improving the algorithm of differentiated use of isosorbide dinitrate, amlodipine and sildenafil based on the peculiarities of the disease. It was found that due to the original approach to early complex assessment of the degree and signs of progression of heart failure in patients with ischemic heart disease in combination with arterial hypertension by performing ultrasound of the heart taking into account the left ventricular ejection fraction, pressure in pulmonary artery and additional ultrasound measure the diameter of vena cava inferior it is possible with a high degree of probability to assess the severity of heart failure and determine the phase of its progression from IIA to IIB and timely apply differentiated medication. To be specific, for patients with HF IIA and hypertension in the pulmonary artery, it is advisable to use amlodipine and consider the possibility of use sildenafil when insufficient clinical efficacy. For patients with HF IIB, isosorbide dinitrate can be used as an emergency drug while normal or high blood pressure are supported, and after stabilization, change to amlodipine or sildenafil. For patients with HF IIB with low left ventricular ejection fraction and systemic low blood pressure, sildenafil should be preferred