Influence of Trimethasidin on Hemodynamic Parameters of the Functional State of Myocardium in Elderly Patients with Comorbidity of Ischemic Heart Disease and Biliary Tract Pathology

Comorbidity becomes a very important problem of the modern medicine. It forms new spiral illness and combines one with the other as separate parts into a single whole. Atherosclerosis is an etiological factor of many diseases afflicting the elderly. Ischemic heart disease and chronic cholecystitis are more common for elderly than for young people. Thus, it is more crucial to study characteristics of their course and to conduct a correction of the patients' treatment. It gives the possibility of prevention a polypharmacy and complications of drugs therapy. In chronic inflammation of the biliary system, there is also an "oxidant stress" and flow of all the above-mentioned processes that exhaust the organism's compensatory mechanisms. Thus, metabolic therapy, as an adaptation factor and recovery of spent energy, is very relevant for patients with coronary artery disease with a combined course of ischemic heart disease and chronic cholecystitis. The purpose of the study was to analyze the effect of trimethazidine on the hemodynamic indications of myocardium in elderly with comorbidity of ischemic heart disease and chronic cholecystitis. Material and methods. We examined 23 elderly patients with comorbidity of ischemic heart disease and chronic cholecystitis. An average age of patients was 62.43.9. The control group consisted of 14 patients of the same age and gender. Results and discussion. The patients of the main group got the following treatment: statin, antiagregant, lysinopril and trimethazidine 35 mg 2 times per day. The obtained data analysis showed an improvement in the pumping function of the myocardium due to an increase in EDV indices by 21% (p <0.05), SV by 36% (p <0.05). The EDVi indices increased by 23% (p <0.05) and SVi – by 36% (p <0.05). The increase in the ΔS values was highlighted to be 19% higher (p <0.05) and Vcf – 25% higher (p <0.01), at the same time a decrease by 29% (p <0.02) was noticed for R. It should be pointed out that trimethazidine is excreted predominantly through the kidneys. Conclusions. On the one hand, the trimetazidine does not impair the flow of chronic cholecystitis; on the other hand, it reduces the tissue reaction of the myocardium to manifestations of local and general inflammation in the body. Thus, trimethazidine positively affects the hemodynamic parameters of the myocardium in patients with comorbidity of ischemic heart disease and chronic cholecystitis, excluding negative effects of the biliary system.