Efficiency of nitrate oxide donor Tivortin in women with post-infarction cardiosclerosis in the perimenopausal period with heart failure
Objective. To study the effectiveness of the effect of L-arginine in women in the perimenopausal period with post-infarction cardiosclerosis with manifestations of heart failure.
Materials and methods. The study included 135 women who were hospitalized at the age from 45 to 60 years. All patients were divided into two groups: group I consisted of 80 women (mean age ‒ 45.1±6.6 years) in the perimenopausal period; group II included 55 women (mean age ‒ 60.6±4.6 years) in the postmenopausal period. The functional state of the heart was investigated by the echo-Doppler method. Treatment and observation continued for 3 months. To identify the effectiveness of the therapy was assessed by monthly echo-Doppler sonography. The first group, against the background of basic therapy (nitrates, β-blockers, antiplatelet agents, statins), additionally received the drug L-arginine 4.2 % (Tivortin) solution of 100 ml intravenously drip for 7-8 days, followed by 5 ml (1 g) 3 times per day inside within 3 months. The second group received only the main therapy without the use of L-arginine.
Results. When conducting a comparative assessment of the structural and functional indicators of the heart in women of the first group, it showed that against the background of the main therapy when receiving the drug L-arginine 4.2 % solution 100 ml intravenously before and after treatment were as follows: left atrium size ‒ 5.13±0.18 up to, 4.61±0.14 after; the size of the right ventricle ‒ 3.11±0.01 up to, 2.90±0.08 after; thickness of the interventricular septum ‒ 1.42±0.05 up to, 1.34±0.04 after; posterior wall thickness of left ventricle ‒ 1.38±0.04 up to, 1.34±0.04 after; index of left ventricle myocardial mass ‒ 127.0±5.4 up to, 112.0±4.7 after; end diastolic volume ‒ 144±0.80 up to, 122.0±6.4 after; minute volume ‒ 4.36±0.20 up to, 5.30±0.20 after; ejection fraction ‒ 48 % up to, 52 % after; stroke volume ‒ 54 ml up to, 62 ml after. Clinically noted an increase in exercise tolerance, a decrease in the frequency of nitrate intake and an improvement in the quality of life.
Conclusions. In women of group 1, against the background of basic therapy with the addition of L-arginine 4.2 %, the functional class of heart failure decreases from II to I, the indicators of diastolic filling of the left ventricle are normalized, and the incidence of repeated myocardial infarction decreases.
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