Dynamics of Cardiohemodynamic Indicators, Profibrotic and Lipidogram Parameters in Patients with Chronic Heart Failure on Background of Coronary Heart Disease and Type 2 Diabetes Mellitus during Treatment with Blockers of Β-Adrenoreceptors

The number of patients with chronic heart failure on the background of a combined course of coronary heart disease and diabetes mellitus type 2 require a personified approach to avoid adverse effects of drugs or even their substitution. The purpose of this study was to determine the effect of both carvedilol and nebivolol as a part of standard therapy on profibrotic marker monocytic chemoattractant protein-1, parameters of cardiohemodynamics and lipidogram in the treatment of patients with chronic heart failure on background of coronary heart disease in combination with type 2 diabetes mellitus. Material and methods. 65 patients with chronic heart failure on background of coronary heart disease and diabetes mellitus type 2 were randomized into 2 groups. Group 1 (n = 35) received standard therapy in combination with carvedilol, the 2nd group was administered nebivalol (n = 30). The cause of chronic heart failure in all patients was coronary heart disease. Echocardiographic studies were conducted using the ultrasound diagnostic apparatus "Radmir" T1228A (Kharkiv, Ukraine). The determination of the content of monocytic chemoattractant protein-1 in serum was carried out by means of an enzyme-linked immune assay using Bender MedSystems GmbH, Austria. The biochemical study included determination of the level of total cholesterol and high density lipoprotein, carried out by peroxidase using a set of Cholesterol Liquicolor reagents from Human (Germany) in heparin-stabilized blood serum. The statistical processing of the obtained results was carried out using the computer program "Statistica 6.0". Results and discussion. Reductions of EDV were found to be 3.5% and 4.1% and EDD were 3.8% and 4.3%, respectively (p <0.05). At the same time there was a decrease in monocytic chemoattractant protein-1 in the carvedilol and nebivolol group by 10.8% and 12% (p <0.05). LDL were decreased by 10.8% and 7.9% (p <0.05), and the HDL increased by 14.5% and 8.7% (p <0.05). Conclusions. Involvement in the treatment scheme of carvedilol or nebivolol resulted in a positive dynamics of the parameters of the morpho-functional state of the left ventricle with a decrease in the activity of the marker of fibrosis monocytic chemoattractant protein-1 in the absence of negative effects from the side of the lipidograms in patients with chronic heart failure on the background of coronary heart disease and diabetes mellitus type 2.