[Quantitative Assessment of Alterations of Reginal Contractility of the Left Ventricle in Patients With Ischemic Heart Disease].

BACKGROUND: An important aspect of ischemic heart disease (IHD) diagnosis is the assessment of alterations of regional contractility (ARC) of the left ventricle. Speckle tracking imaging is a relatively new diagnostic method used for this purpose. Aim of this study was to identify optimal parameters of left ventricular (LV) deformation by speckle-tracking echocardiography which can differentiate quantitatively degrees of ARC of all left ventricular segments in patients with acute and chronic forms of IHD. MATERIALS AND METHODS: We compared parameters of LV longitudinal, radial, and circular deformation in 216 patients with IHD in dependence on the presence of ARC. RESULTS: The most sensitive and specific indicator of ARC of LV anterior septal wall was found to be the value of longitudinal systolic deformation of the middle and apical segments (diagnostic thresholds -13.5 % and 14.7 %, respectively). Such indicator for LV inferior wall was value of circular systolic strain (diagnostic threshold for the basal segment -12.9 %, for the middle segment -10.7%).

[Assessment of Efficacy of Combined Pharmacotherapy With Fixed Perindopril/Amlodipine Combination in Patients With Combined Cardiovascular Pathology in Outpatient Practice].

AIM: to study effects of using fixed perindopril/amlodipine combination in complex treatment of patients with combined cardiac pathology in active observation mode, in comparison with other angiotensin converting enzyme (ACE inhibitors) or angiotensin II receptor antagonists (ARA), including free combination with calcium channel blockers (CCB) in conditions of routine outpatient practice. MATERIALS AND METHODS: The design of the study included two stages: I - monitoring effectiveness of pharmacotherapy performed in routine outpatient practice (duration of 2 months), II - "active treatment (management)" - changing the pharmacotherapy scheme in patients who did not reach the target level of "office" blood pressure (BP), monitoring patients for 6 months and carrying out, if necessary, dose correction of the newly appointed treatment regimen. The study included 50 patients aged 45-65 years with combined cardiovascular pathology: II-III degree arterial hypertension, I-III functional class (FC) stable angina pectoris, I-III FC chronic cardiac failure. RESULTS: Number of patients who reached target level of office BP by the end of active observation was 41 (p.

[Comparative Assessment of Effects of Free and Fixed Combinations of Hypotensive Drugs on Quality of Life of Patients With Arterial Hypertension of High and Very High Risk].

PURPOSE: comparative assessment of effects of free and fixed combinations of hypotensive drugs on quality of life (QL) of patients with arterial hypertension (AH) of high and very high risk of cardiovascular complications. MATERIAL: Study group comprised 120 patients (70% men, 30% women, age 45-65 years) with degree II (20.9%) and III (79.1%) A. Duration of AH was 10.6+/-2.89 years. Risk was high in 58 (48.3%), very high - in 62 (51.7%) patients. Patients were randomized into 3 groups with different second step therapy. Patients of group 1 received amlodipine + ramipril, group 2 - amlodipine + lisinopril, group 3 - fixed amlodipine/lisinopril combination. If necessary bisoprolol and indapamide were added at 3-rd and 4-th step, respectively. Assessment of QL was carried out prior to therapy and at the end of 14-th week of intervention by means of Short Form-36 (SF-36). RESULTS: Use of fixed amlodipine/lisinopril combination in patients with AH with high and very high risk of cardiovascular complications compared with free combinations of amlodipine and lisinopril or ramipril was associated with statistically significant improvement of a number of QL parameters as assessed by SF-36 questionnaire: physical functioning, bodily pain, general health, social functioning, and mental health.