DYNAMICS OF HYPERTROPHY INDICATORS AND LEFT VENTRICULAR REMODELING IN PATIENTS WITH DECOMPANSATED HEART FAILURE IN THE POST-INFARCTION PERIOD AFTER REMEDIAL TREATMENT

The aim of the study was to assess the main indicators of hypertrophy and remodeling of the left ventricle in patients after myocardial infarction, complicated by decompensated heart failure and to determine the dynamics of their changes in the background of treatment with succinic acid and preparations of arginine. Materials and Methods. There were examined 120 patients with Q-QS wave and non-Q wave myo-cardial infarction; stage II A-B decompensated chronic heart failure according to the classification proposed by Vasylenko V. Kh. and Strazhesko M. D., the New York Heart Association functional class III-IV. Study groups were homogenous by age, gender, disease severity, dura-tion of the post-infarction period, clinical signs of de-compensation, that served as a basis for inclusion of the patients in the study. All patients have an echocardio-graphic examination on the CARIS PLUS device (Bio-medice, Italy). In all the patients, the indicators of remodeling LV such as end-diastolic dimension (EDD), LV end-diastolic volume (EDV), LV interventricular septal thickness (IVST) in systole and diastole, LV posterior wall thickness (PVT) in systole and diastole, LV myocardial mass (MM), LV myocardial mass index (MMI), LV radius to wall thickness ratio were assessed. The patients with Q-QS myocardial infarction (60 individuals) and with non Q myocardial infarction (60 patients) were divided into 4 groups depending on the treatment methods. Results of the research and their discussion. During 2 months of treatment with transmitted myocardial infarction, there were significant improvements in hemodynamics parameters of the left ventricle function and its contractive ability. Such indicators, as EDD, ESD, EDV, ESV, IVST in systole and diastole, LV PVT in systole and diastole, LV MM, LV MMI, LV radius to wall thickness ratio were significantly lower in all of the examined patients, especially those who, with standard therapy, received a combination of succinic acid and preparations of arginine Analyzing echo-cardiological indicators in patients after non-Q MI, complicated with decompensated HF have been installed a significant increase of metric and volume values of LV after 1 and 2 months of treatment. Thus, there was a significant decrease of LV MM, especially in the fourth group of patients, where the combination of proposed drugs were used. LV MM in this group before treatment was 412.53 ± 2.59 g before treatment, after 1 month of treatment (263.20 ± 4.21) g (p˂0.05) and 2 months (218.53 ± 3.34) g (p˂0.05). There was also a positive dynamics of increasing of EF LV and decreasing pulmonary arterial pressure in patients after Q and non-Q MI and decompensated HF. Conclusions. Application in patients after a my-ocardial infarction, complicated by decompensated heart failure, succinic acid and arginine preparations allows to improve the metric and volume parameters of the heart. The results of the study have shown that the use of a combination of standard therapy and succinic acid and preparations of arginine can significantly enhance the effectiveness of the first, which, to some extent, mani-fests itself, in the restraint of primary and secondary remodeling of the left ventricle. That is why the applica-tion, along with basic therapy, of these drugs is appropri-ate for this contingent of patients.