Кубанский научный медицинский вестник (Feb 2014)
REGULATORY ADAPTIVE STATUS IN EVALUATION OF EFFECTIVENESS OF MEDICATION THERAPY IN PATIENTS WITH CHRONIC HEART FAILURE OF FUNCTIONAL CLASS III
Abstract
100 patients with CHF FC III against the background of ischemic heart disease (IHD) and/or stage III hypertensive disease (HD) who received complex therapy (quinapril, torasemide, spironolactone) took part in the research. Upon randomization, Group 1 consisted of 56 patients (57,5±21,7 years old) and received metoprolol succinate of sustained release (betalok ZOK, Sweden’s, «AstraZeneca», 59,1±12,7 mg per day). Group 2 consisted of 44 patients (57,1±21,4 years old) and received Ivabradine, inhibitor of If channels in the sinoatrial node (coraxan, France’s, Servier, 12,1±4,6 mg per day) in cases when use of beta-blockers (BB) was not possible. VO2max treadmill tests, echocardiography, 24-hour blood pressure monitoring, NT-proBNP blood plasma test were done initially and 6 months in. A cardiorespiratory synchronism test was done in order to objectively evaluate the regulatory adaptive status (RAS). Complex therapy with the use of Ivabradine showed comparable clinical effects with metoprolol succinate: improved the structural and functional condition of the myocard, increased tolerance to physical exercise, caused positive shifts in the level of NT-proBNP in blood plasma and VO2мах during physical strain, but more than BB positively influenced the RAS. Therefore, Ivabradine can serve as an alternative to BB if it’s impossible to use in patients with CHF FC III against the background of IHD and/or stage III HD.
