Background. Morbidity and mortality in patients with functional mitral regurgitation (FMR) remains high, however, no pharmacological therapy has been proven to be effective.Aimsto study the effect of sacubitrile/valsartan and valsartan on functional mitral regurgitation in chronic heart failure.Methods.This double-blind study randomly assigned sacubitrile/valsartan or valsartan in addition to standard drug therapy for heart failure among 100 patients with heart failure with chronic FMR (secondary to left ventricular (LV) dysfunction). The primary endpoint was a change in the effective area of the regurgitation hole during the 12-month follow-up. Secondary endpoints included changes in the volume of regurgitation, the final systolic volume of the left ventricle, the final diastolic volume of the left ventricle, and the area of incomplete closure of the mitral valves.Results.The decrease in the effective area of the regurgitation hole was significantly more pronounced in the sacubitrile/valsartan group than in the valsartan group (0.070.066against0.030.058sm2; p=0.018)in the treatment efficacy analysis, which included 100patients (100%). The regurgitation volume also significantly decreased in the sacubitrile/valsartan group compared to the valsartan group (mean difference:8.4ml; 95%CI, from 13.2 until 1.9;р=0.21). There were no significant differences between the groups regarding changes in the area ofincomplete closure of the mitral valves and LV volumes, with the exception of the index of the final LV diastolic volume (p=0.07).Conclusion.Among patients with secondary FMR, sacubitril/valsartan reduced MR more than valsartan. Thus, angiotensin receptor inhibitors and neprilysin can be considered for optimal drug treatment of patients with heart failure and FMR.
It is known that low body mass index is a statistically significant predictor of death rate in patients with COPD. The purpose of
our research comprised in evaluation of peculiarities of respiratory function parameters in patients with COPD and metabolic syndrome
depending on body mass index. All patients were divided into groups: those who have only COPD, those who have combination of COPD
and metabolic syndrome, they were subdivided into 3 subgroups, depending on body mass index (with normal body mass index, excess
body mass index, and obesity). As a result of the research, it was found out that emphysematous respiratory disorders prevailed among
patients with COPD and normal body mass index. Symptoms of obstructive bronchitis were found in patients with combination of COPD
and metabolic syndrome, and excess body mass index values.
The regress or left ventricular (LV) hypertrophy is a main end-point of antihypertensive therapy. The aim of the present study
was to compare antihypertensive effects of two fixed combination preparations of ACE inhibitor and thiazide diuretic, enalapril 20 mg/hydrochlorthiazide
12,5 mg (Co-renitec) and losartan 50 mg/hydrochlorthiazide 12,5 mg (Hyzaar) on LV mass index (LVMI), types of left
ventricular remodeling in patients with grade II-III arterial hypertension. First group was treated with Co-renitec, second group with
Hyzaar during 24-weeks period. Results showed that both preparations significantly and to the same degree decrease LVMI. Number of
patients with normal LV geometry increases with accompanying decrease in number of patients with concentric hypertrophy and concentric
remodeling. The favorable effects were more remarkable in group treated with Hyzaar.
Артериальная гипертония (АГ)-заболевание, характеризующееся повышением систолического (САД) и/или диастолического артериального давления (ДАД) от 140/90 мм рт.ст. и более. АГ является актуальной проблемой современной медицины. В ряде крупных международных исследований, в которых принимали участие десятки тысяч больных АГ, показано, что снижение артериального давления (АД) приводит к уменьшению частоты сердечно-сосудистых заболеваний и смертности [1-6]. В исследовании HOT (Hypertension Optimal Treatment Study) определен целевой уровень АД, при котором риск осложнений сведен к минимальному [1]. В настоящее время возможно использование 2 стратегий стартовой терапии АГ: монотерапии и низкодозовой комбинированной терапии с последующим увеличением количества и/или дозы лекарственного средства при необходимости [7]. Комбинированная терапия имеет ряд преимуществ: • усиление антигипертензивного эффекта за счет разнонаправленного действия лекарств на патогенетиче-Сведения об авторах:
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