Kravchun P. Clinical, pathogenetic, diagnostic and therapeutical aspects of chronic heart failure progression in patients with postinfarction cardiosclerosiscombined with type 2 diabetes mellitus and obesity.

The dissertation presents clinical and pathogenetic substantiation of concepts that optimize the efficiency of diagnosis, prognosis and individualized treatment of chronic heart failure in patients with postinfarction cardiosclerosis combined with type 2 diabetes mellitus and obesity based on a comprehensive study of the role of adipose tissue hormones,neurohumoral activationbiomarkers, lipid, carbohydrate profiles and hemodynamic parameters. The obtained results indicate that the progression of chronic heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity occurred in parallel with increased levels of fractalkinemia and vaspinemia and reduce clusterinemia and omentinemia that is associated with hyperglycemia, hyperinsulinemia, atherogenic changes in lipid profile, postinfarction remodeling progression by increasing the volume and size of the heart, left ventricle contractile capacity depletion. There were established gender and age characteristics of the chronic heart failure progression based on analyse of carbohydrate and lipid metabolism, fractalkin and clusterinactivity, hormone imbalance of adipose tissue and hemodynamic parameters. Thre were retrieved priority data for forecasting the progression of chronic heart failure considering the dynamics of individual clinical, biochemical and hemodynamic parameters. The efficiency of the different combination therapy schemes use to individualization of treatment of chronic heart failure in patients with polymorbidity of postinfarction cardiosclerosis, type 2 diabetes mellitus and obesity was confirmed in conditions for a positive impact on the studied parameters in patients.