Affiliation:
1. Yevdokimov Moscow State University of Medicine and Dentistry
2. City Clinical Hospital No. 52
Abstract
Introdiction. The article highlights the importance of optimizing the treatment of chronic heart failure (CHF) in patients with comorbid cardiopulmonary pathology, namely ischemic heart disease (CHD) in combination with chronic obstructive pulmonary disease (COPD). The results of our own research on the evaluation of the clinical efficacy of trimetazidine inclusion in the complex therapy of comorbid pathology are presented.Objective. To study the clinical efficacy of trimetazidine as part of the complex therapy of patients with ischemic heart failure in combination with COPD.Materials and methods. 60 patients with CHF II-III FC, left ventricular ejection fraction (LVEF) <45% were studied against the background of postinfarction cardiosclerosis and COPD of 2–3 degrees of airflow restriction. The patients were divided into 2 groups: 1st (30 patients) took trimetazidine; 2nd (30 patients) received therapy without the addition of trimetazidine. The dynamics of: clinical condition with the use of SHOCK, FC CHF, test with 6-min. walking, quality of life (MLHFQ, SGRQ), indicators of 24-bifunctional monitoring, TTE, spirometry, platelet aggregation and blood viscosity.Results and conclusion. The use of trimetazidine as part of therapy led to an improvement in the clinical course of the disease, significantly increased exercise tolerance. The number and duration of ischemia episodes decreased by 34 and 39% (p < 0.05). The number of angina attacks per week and the need for nitroglycerin decreased by 65% and 42% (p < 0.05), respectively. There was an improvement in intracardiac and peripheral hemodynamics. Thus, LV LV increased by 21%, pulmonary artery pressure decreased by 18%, the indicators of LVD, platelet aggregation and blood rheology improved. There was a more positive dynamics of lipid peroxidation and antioxidant system indicators compared to the control group.
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