Aim: to study the activity of eNOS, the concentration of L‑arginine and stable nitric oxide metabolites, as well as the degree of endothelium dependent vasodilation with 5‑minute compression test of the brachial artery in patients with chronic heart failure (CHF) of ischemic origin depending on L‑arginine administration in the treatment scheme.Material and methods. In the present study were included 303 patients (204 men and 99 women) observed about CHF ischemic genesis. Patients of the main group A+ (101 persons), in addition to the main treatment, took L‑arginine at a dose of 1 g 3 times per day in syrup (Tivortin), the rest of the patients (202 persons) were included in the comparison group А - . As a control group were examined 20 healthy volunteers. The metabolism of NO and endothelium-dependent vasodilatation were studied by determining the activity of eNOS, and concentration of NO2/NO3, determining the level of L‑arginine in the blood, assessment of endothelial function with a compression test. The endothelial function of vessels was judged according to the dopplerography of the brachial artery using the method of Solomon et al.Results. In patients taking arginine were observed additional positive effect on the arginine concentration in the peripheral blood (51,63% against 43,53% in group A, p<0.01). The distribution of the patients according to the status of LV systolic function showed that the effect of additional application of arginine is observed only in patients with low LVEF (69,63% vs 58,32% in the group with low LVEF, p<0.01). Also it was discovered that the use of arginine promotes a significantly greater increase in eNOS activity (11,53% against 4.76 per cent, p<0.001. In comparison with patients within the groups A+ and A —, classified according to the state of LV systolic function, it was found a significantly more pronounced effect of arginine in patients with normal systolic LV function.Conclusions. Patients with chronic heart failure (CHF) of ischemic origin, with low left ventricle ejection fraction (LV EF), a violation of NO metabolism is noted. Decrease of L‑arginine concentration leads to decrease in endothelial NO-synthase activity, and increase of macrophage NO-synthase activity leads to high concentration of nitric oxide and its stable metabolites in peripheral blood. Endothelial vasomotor dysfunction is associated with decrease of vasodilatation and even paradox vasoconstriction (in our study in 10 patients (3.3%)). Inclusion of L‑arginine to standard therapy of CHF gives additional positive effect on improvement of metabolism of nitric oxide and endothelial vasomotor function.