Regulatory Adaptive Status Research Articles

INFLUENCE OF QUINAPRIL ON THE REGULATORY-ADAPTIVE STATUS OF PATIENTS WITH CHRONIC HEART FAILURE HYHA CLASS I: RESULTS OF NOT COMPARATIVE STUDY

Aim. To assess effects of quinapril on the regulatory-adaptive status (RAS) in patients with chronic heart failure (CHF) NYHA class 1 and arterial hypertension (HT). Material and methods. Patients (n=49) with CHF NYHA class I and HT stage I–II (25 men and 24 women, aged 52.5±8.4 years) were included into an open noncomparative study. A cardio-respiratory synchronization (CRS) test, 6 minute walk test, treadmill test with evaluation of the maximal oxygen uptake during exercise, ambulatory blood pressure monitoring, echocardiography , determination of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) plasma level were performed at baseline and after 6 months of quinapril therapy. Results. The quinapril treatment (average daily dose 17.3±7.9 mg) improved myocardium structural and functional parameters, increased the exercise tolerance, reduced neurohumoral activity , improved the RAS according to CRS test: increase in synchronization range of cardiorespiratory cycles per minute from 8.0±2.1 to 11.0±2.5 (Δ27.3%; p<0.01), as well as RAS index from 52.6±7.8 to 89.7±8.9 (Δ41.4%; p<0.01), and decrease in the duration of CRS development at the minimal border of cardiac cycles from 15.5±3.5 to 12.9±2.8 (Δ15.8%; p<0.01). Conclusion. Quinapril has a positive effect on the RAS in patients with CHF NYHA class I and HT of stage I–II.

Ivabradine therapy effectiveness in patients with chronic heart failure, Functional Class III

Aim. To assess the effectiveness of ivabradine-including therapy, as well as the effects of ivabradine on regulatoryadaptive status (RAS), in patients with chronic heart failure (CHF), Functional Class (FC) III. Material and methods. The study included 100 patients with FC III CHF and coronary heart disease (CHD) and/ or Stage III arterial hypertension (AH). The participants were previously prescribed a complex treatment regime. After randomisation, Group I included 56 patients (mean age 62,9±1,8 years), who were additionally administered metoprolol succinate extended-release (mean dose 59,1±4,5 mg/day). Group II (n=44; mean age 59,4±1,3 years) was additionally administered an If channel inhibitor ivabradine, when beta-adrenoblocker (BAB) therapy was not possible. At baseline and 6 months later, participants underwent treadmill test (with VO2max assessment), echocardiography, 24-hour blood pressure monitoring, and the measurement of plasma levels of N-terminal probrain natriuretic peptide (NT-proBNP). RAS status was qualitatively assessed in a cardio-respiratory synchronism test. Results. Ivabradine-including therapy improved myocardial structure and function, increased exercise capacity, and demonstrated positive effects on plasma NT-proBNP levels, VO2мах during treadmill test, and RAS status.Conclusion. Ivabradine could be an alternative medication when BAB therapy is not possible in patients with FC III CHF and CHD and/or Stage III AH.