Object of the study: Diastolic HF of functional class II in patients with stage II HD, stage III HD combined with CAD and those with sarcoidosis and systemic lupus erythematosus. Purpose of the study: To work out pathogenetically substantiated approaches to drug therapy of the patients with diastolic heart failure of various origin based on investigation of structural geometric remodeling of the left heart ventricle, its dysfunction and immune system disorders, their association and dynamics under the influence of drug therapy. Methods of the investigation: General clinical, instrumental, functional, laboratory, statistical. Theoretical and practical results: It was suggested to perform a test with 6-min walk in patients with HD, SS and CLU with diastolic variant of HF to reveal progressive remodeling of left heart chambers. To assess the dynamics of LV diastolic function, it is suggested to determine the parameters of the immune state which correlate with severity in patients with stage III HD with postinfarction cardiosclerosis (serum concentration of IL-4 and IL-6 and serum content of phagocyting neutrophils). The method sensitivity and specificity were 100 and 88.9%. respectively. In patients with SS it is recommended to determine serum con-centrations of IL-1?, IL-4, IL-6 and TNF? (sensitivity and speci-ficity of the method is 100%), in patients with SLE – serum concentrations of IL-4, IL-6 and CIC (sensitivity and specificity of the method 100 and 50%). To optimize the treatment of SS and SLE in patients with diastolic variant of FC II HF, it is recommended to include ACEI in the treatment protocol. To improve the efficacy of treatment of patients with stage II HD with diastolic variant of FCII HF, is recommended to combine ACEI enalapril and ARA II candesartan in individual doses. To predict the treatment efficacy in patients with stage II HD, SAS and SLE with diastolic variant of FC II HF, is recommended to use the worked out prognostic criteria. Novelty: For the first time, a concept developmentand progress of LV DD at various diseases was suggested based on the analysis of the results of clinical, instrumental and laboratory investigations. It was established that reduction of the distance in 6-min walk test in patients with HD, SS and SLE by 40 % was associated with progressive enlargement of the left heart chambers. It was proven that elevation of serum concentrations of IL-4 and IL-6 was associated with LV diastolic dysfunction irrespective of its etiology. A method of prognosis of the efficacy of correction of clinical functional state of the patients with diastolic HF of various etiology was suggested. Degree of introduction: The findings of the research were intro-duced to the work of the respective departments of Kharkiv City Out-patient Hospitals No. 8, 9, 10, 26, Kharkiv Regional Stu-dents’ Hospital, Kharkiv City Clinical Hospital of Urgent Medical Aid, Family Physician Office of UCC “Internationalist”, Chuguiv CDH, Kupiansk CDH (Kharkiv Region), Kremenchuk Hospital No. 3 (Poltava Region),Sumy Clinical Hospital No. 1. The find-ings of the research are used at preparation of the lectures for trai-nees of department of therapy and nephrology of Kharkiv Medical Academy for Post-graduate Training (Ministry of Health of Ukraine). Sphere of application: medicine, cardiology.
