Aim. To evaluate the effectiveness of morpholinium-methyl-triazolyl-thioacetate (thiotriazoline) as a cardioprotector in patients with non-Hodgkin’s lymphomas who received chemotherapy with the inclusion of anthracyclines.Material and methods. Fifty patients with non-Hodgkin’s lymphomas were examined on the background of antitumor therapy. The patients were divided into 2 following groups: group 1 (n=27) — standard chemotherapy; group 2 (n=23) — thiotriazoline as a cardioprotector. The quality of life was assessed using the SF-36 questionnaire; the level of troponin I and the natriuretic peptide NT-proBNP was determined; an electrocardiography and echocardiography were performed.Results. In the course of the study, significant differences (p<0,05) were found in following parameters: the severity of dyspnea and lower limb edema, alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, troponin I level, NT-proBNP, corrected QT interval, end systolic volume, left ventricular ejection fraction, E/A ratio. The results obtained indicate the clinical and paraclinical advantage of thiotriazoline and reflect its cardioprotective effect. Conclusion. The use of thiotriazoline makes it possible to prevent and slow down the cardiovascular disease continuum, leading to the development of heart failure or decompensation that exists in this category of patients. Keywords: cardio-oncology, thiotriazoline, heart failure, anthracyclines, cardiotoxicity>˂0,05) were found in following parameters: the severity of dyspnea and lower limb edema, alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, troponin I level, NT-proBNP, corrected QT interval, end systolic volume, left ventricular ejection fraction, E/A ratio. The results obtained indicate the clinical and paraclinical advantage of thiotriazoline and reflect its cardioprotective effect.Conclusion. The use of thiotriazoline makes it possible to prevent and slow down the cardiovascular disease continuum, leading to the development of heart failure or decompensation that exists in this category of patients.
Aim. To evaluate the effectiveness of serelaxin with subsequent quadritherapy in the treatment of patients with acute decompensation of heart failure in the long term outcomes.Material and Methods. A five-year observational, comparative, longitudinal study was conducted with the participation of 34 patients with heart failure. Standard laboratory and instrumental methods of examination were performed, including the determination of the level of Nt-proBNP, electrocardiography, echocardiography. The quality of life was assessed on the basis of the SF-36 questionnaire, the state of health using a visual analog scale (VAS), a survival forecast was made using the MAGGIC scale and the Seattle Heart Failure Model calculator. The assessment of adherence to treatment was carried out using the questionnaire “COP-25”.Results and Discussion. With serelaxin therapy at the 14th day, there was a significant decrease (p ˂ 0,05) of Nt-proBNP level, pulmonary artery pressure, as well as an increase of left ventricular (LV) ejection fraction (EF) by an average of 5%, which coincided with the leveling of manifestations of heart failure (HF) decompensation and improvement of clinical and instrumental parameters. There was a statistically significant (p ˂ 0,05) improvement in the quality of life based on the patient’s subjective assessment. Stable positive dynamics was recorded on the basis of the SF-36 questionnaire for all health indicators, not only physical, but also social and mental. Subsequent quadrotherapy reduced the mortality rate of patients in the study cohort of patients, as well as increased adherence to treatment.Conclusion. The use of serelaxin does not lead to a decrease in cardiovascular mortality, however, it reduces the number of hospitalizations due to acute decompensation of heart failure. The subsequent quadrotherapy leads to an increase in the quality of life, physical, social activity and adherence to the treatment. Reverse remodeling of the left heart chambers and an increase in EF LV is characterized by a decrease of the functional class of CHF, which indicates the influence of this therapy on the key pathogenetic mechanisms of the disease.
This review discusses a number of aspects of surgical methods for treating severe chronic heart failure: resynchronizing therapy, mechanical circulatory support systems, and heart transplantation. Surgical methods for the treatment of heart failure are a rapidly developing field of modern cardiology and cardiac surgery. The main surgical method of treatment was and remains orthotopic transplantation of a donor heart. The advent of implantable systems has affected the problem of heart transplantation. Over the past decade, the use of mechanical circulatory support systems has grown significantly. At the moment, there are 3 main directions: creating devices for auxiliary blood circulation, various modes and methods of electrical stimulation of the myocardium, creating devices that mechanically remodel the heart chambers (left ventricle). All of these directions to some extent (depending on the evidence base) have found their place in modern recommendations for the treatment of chronic heart failure. The use of mechanical left ventricular remodeling shows good results in patients suffering from symptomatic heart failure, which leads to a significant and persistent decrease in the volume of the left ventricle and improvement of its function, symptoms and quality of life. Despite the fact that at the moment the geography and prevalence of their use is small, the number of implanted devices will only grow. Thus, given the need for frequent hospitalizations and high treatment costs, it is necessary to improve modern methods of surgical treatment of severe and terminal heart failure, make them more accessible, which will affect the duration and quality of life of these patients.
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