The dissertation was intended to propose the most optimal way of forecasting the unfavorable course of chronic heart failure in patients with coronary heart disease with additional factors of cardiovascular risk and to improve the methods of pharmacological intervention, which was made based on the analysis of the weighted diagnostic and prognostic significance of clinical anamnestic, phenotypic, cardioghemodynamic, neurohumoral and metabolic factors. It was used differet clinical and anamnestic methods: echocardiography, measurement of physical activity tolerance, determination of the circulating level of biomarkers, that characterize various stages of the pathogenesis of CHF (NT-pro-BNP, galectin-3, high-sensitivity C-reactive protein, osteoprotegerin, insulin resistance index, the number of prohangio-genous circulating endothelial progenitor cells with immune phenotypes CD14+CD309+ and CD14+CD309+Tie-2+). It was developed he concept about the role of the endogenous reparative system of the heart and blood vessels by determining the number of proangiogenic circulating endothelial progenitor cells in an individualized assessment of adverse clinical events risk and the prediction of the effectiveness of treatment in patients with ischemic CHF. it was carefully analyzed the contribution of traditional (diabetes mellitus) and additional metabolic risk factors: asymptomatic hyperuricemia, subclinical hypothyroidism, insulin resistance in patients with ischemic CHF. Study design: An open, cohort, controlled, prospective trial in parallel groups with a retrospective post-hoc analysis of 388 patients with CHF of ischemic genesis in the presence of more than one additional metabolic factor of cardiovascular risk and 50 practically healthy persons of the same age and sex. At the first stage, the association between the clinical course of CHF, on the one hand, and the severity and phenotype of CHF, parameters of cardiac hemodynamics, features of cardiovascular remodeling, estimated on the basis of echocardiography and levels of biomarkers, reflecting various pathogenetic mechanisms of formation and progression of CHF, was carried out. The second stage included a prospective and retrospective analysis of the course and effectiveness of treatment for patients with CHF using selected biomarkers. At this stage, the frequency of fatal and non-fatal cardiovascular events, including re-hospitalization, and the incidence of fatal outcome for any reason in a cohort of 388 patients with CHF for 3 years of follow-up was studied.
