K. Karpenko, V. Chernyak, D. Dubenko, O. Kuzmenko, E. Biłyk, P. F. Muzychenko
The article deals with classification issues, the current state of medical and surgical treatment of chronic diseases of the veins of the lower extremities, widely used in world practice, innovative domestic developments based on electrocoagulation and electric welding technologies, as well as their comparative characteristics among themselves and with laser methods based on their own experience. The aim — to compare effectiveness of open and minimally invasive surgical techniques in patients with varicose disease (VD) and post‑thrombotic disease (PTD) of the lower extremities, to assess the possibility of Ukrainian high‑tech developments using. Materials and methods. Analysis was conducted of surgical treatment of 94 patients with VD for the period from 2014 to 2017 and 81 patients with PTD (the period from 2002 to 2010) in the «Olexandrivska» clinical hospital in Kyiv. Results and discussion. The results of treatment were evaluated at 4 weeks, 3 months, and 6 months after surgery by sonographic criteria, the presence of local edema, the dynamics of the trophic changes in soft tissue of the shin. After 1 month, a slight improvement was fixed at 18 % of the patients of the main group, moderate improvement — at 74 %, significant improvement — at 8 %. In 3 months the estimated effectiveness was 2 %, 12 %, 86 %, in 6 months — 2 %, 6 %, 92 %, respectively. The average length of hospital stay for patients in the main group was 2.4 ± 0.4 days, whereas in the control group this indicator was 5.2 ± 1.2 days. Conclusions. Endovenous laser coagulation and subfascial endoscopic dissection are effective, low‑impact methods for treating lower limb varicose and post‑thrombotic diseases of the lower extremity veins and should actively supplant open methods of surgical treatment. Ukrainian developments using high‑frequency electric welding and electrocoagulation technologies could take leading positions in phlebology.
{"title":"Efficiency of various methods of surgical treatment of chronic diseases of lower limb veins (analysis of our experience)","authors":"K. Karpenko, V. Chernyak, D. Dubenko, O. Kuzmenko, E. Biłyk, P. F. Muzychenko","doi":"10.30978/HV2019-1-45","DOIUrl":"https://doi.org/10.30978/HV2019-1-45","url":null,"abstract":"The article deals with classification issues, the current state of medical and surgical treatment of chronic diseases of the veins of the lower extremities, widely used in world practice, innovative domestic developments based on electrocoagulation and electric welding technologies, as well as their comparative characteristics among themselves and with laser methods based on their own experience. The aim — to compare effectiveness of open and minimally invasive surgical techniques in patients with varicose disease (VD) and post‑thrombotic disease (PTD) of the lower extremities, to assess the possibility of Ukrainian high‑tech developments using. Materials and methods. Analysis was conducted of surgical treatment of 94 patients with VD for the period from 2014 to 2017 and 81 patients with PTD (the period from 2002 to 2010) in the «Olexandrivska» clinical hospital in Kyiv. Results and discussion. The results of treatment were evaluated at 4 weeks, 3 months, and 6 months after surgery by sonographic criteria, the presence of local edema, the dynamics of the trophic changes in soft tissue of the shin. After 1 month, a slight improvement was fixed at 18 % of the patients of the main group, moderate improvement — at 74 %, significant improvement — at 8 %. In 3 months the estimated effectiveness was 2 %, 12 %, 86 %, in 6 months — 2 %, 6 %, 92 %, respectively. The average length of hospital stay for patients in the main group was 2.4 ± 0.4 days, whereas in the control group this indicator was 5.2 ± 1.2 days. Conclusions. Endovenous laser coagulation and subfascial endoscopic dissection are effective, low‑impact methods for treating lower limb varicose and post‑thrombotic diseases of the lower extremity veins and should actively supplant open methods of surgical treatment. Ukrainian developments using high‑frequency electric welding and electrocoagulation technologies could take leading positions in phlebology.","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73517782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Amosova, K. P. Lazareva, Yu. V. Rudenko, G. Mostbauer, P. Lazariev, N. Shyshkina, O. Vasylenko
The aim — to compare the effect of 6‑month treatment of patients with arterial hypertension (AH) of 1 — 2 degrees with angiotensin converting enzyme (ACE) or angiotensin II receptor blockers (ARB) in combination with a thiazide diuretic (indapamide) and dihydropyridine calcium channel blockers (CCB) in combination with a diuretic on indicators of brachial and central arterial pressure (AP), elastic properties of the arteries and the structural and functional state of the heart, depending on age. Materials and methods. The study included 320 patients (156 men and 164 women) aged from 35 to 80 years (mean age 62.8 ± 0.61 years) with uncomplicated AH of stage I — II, degree 1 — 2 (62.0 % and 38, 1 %, correspondingly). Depending on age, the patients were divided into two groups: 0.05). In both subgroups of patients aged 0.05). In the group treated with Arifam , the baseline HR values correlated with AP (r = –0.357, p 0.05). In patients aged ≥ 65 years, the antihypertensive effect of therapy with the combination of ACE inhibitor/ARB and indapamide was not accompanied by changes in MMI LV and indicators of LV systolic and diastolic function (all p > 0.05). In the group treated with Arifam there was a decrease in end‑diastolic and end‑systolic volumes (by 9.7 % (p 0.05). Conclusions. In spite of the same positive effect of 6‑month therapy with combinations of ACE inhibitors/ARB with indapamide and BPC with indapamide on brachial and central AP in older patients with hypertension of 1 — 2 degrees, the fixed combination of BPC amlodipine with indapamide ( Arifam ) had an advantage over the combination based on an ACE inhibitor (ARB) regarding the reduction of brachial, central, mean brachial and mean central AP, augmentation, pulse wave velocity, MMI of LV, left atrium volume index, E/e’ of LV, which was associated with an increase in heart rate (an average of 4.6 per 1 min).
{"title":"Differences in the effects of various classes of antihypertensive drugs in combination therapy on indicators of arterial hemodynamics, vascular wall stiffness and structural-functional state of heart in patients with arterial hypertension of 1 — 2 degrees","authors":"K. Amosova, K. P. Lazareva, Yu. V. Rudenko, G. Mostbauer, P. Lazariev, N. Shyshkina, O. Vasylenko","doi":"10.30978/hv2018-4-14","DOIUrl":"https://doi.org/10.30978/hv2018-4-14","url":null,"abstract":"The aim — to compare the effect of 6‑month treatment of patients with arterial hypertension (AH) of 1 — 2 degrees with angiotensin converting enzyme (ACE) or angiotensin II receptor blockers (ARB) in combination with a thiazide diuretic (indapamide) and dihydropyridine calcium channel blockers (CCB) in combination with a diuretic on indicators of brachial and central arterial pressure (AP), elastic properties of the arteries and the structural and functional state of the heart, depending on age. Materials and methods. The study included 320 patients (156 men and 164 women) aged from 35 to 80 years (mean age 62.8 ± 0.61 years) with uncomplicated AH of stage I — II, degree 1 — 2 (62.0 % and 38, 1 %, correspondingly). Depending on age, the patients were divided into two groups: 0.05). In both subgroups of patients aged 0.05). In the group treated with Arifam , the baseline HR values correlated with AP (r = –0.357, p 0.05). In patients aged ≥ 65 years, the antihypertensive effect of therapy with the combination of ACE inhibitor/ARB and indapamide was not accompanied by changes in MMI LV and indicators of LV systolic and diastolic function (all p > 0.05). In the group treated with Arifam there was a decrease in end‑diastolic and end‑systolic volumes (by 9.7 % (p 0.05). Conclusions. In spite of the same positive effect of 6‑month therapy with combinations of ACE inhibitors/ARB with indapamide and BPC with indapamide on brachial and central AP in older patients with hypertension of 1 — 2 degrees, the fixed combination of BPC amlodipine with indapamide ( Arifam ) had an advantage over the combination based on an ACE inhibitor (ARB) regarding the reduction of brachial, central, mean brachial and mean central AP, augmentation, pulse wave velocity, MMI of LV, left atrium volume index, E/e’ of LV, which was associated with an increase in heart rate (an average of 4.6 per 1 min).","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81753087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chernyakhivsky Brothers: from the San River to the Don River","authors":"D. Dubenko","doi":"10.30978/hv2018-4-102","DOIUrl":"https://doi.org/10.30978/hv2018-4-102","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82880272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Voronkov, G. Dudnik, A. Liashenko, L. Mhitaryan, T. Gavrilenko
Мета роботи — вивчити основні клініко‑гемодинамічні та лабораторні характеристики у госпіталізованих пацієнтів з хронічною серцевою недостатністю (ХСН) залежно від динаміки азотовидільної функції нирок у період подолання декомпенсації та оцінити прогностичне значення погіршення ниркової функції (ПНФ) в цієї категорії пацієнтів. Матеріали і методи. Обстежено 134 пацієнти з ХСН, зумовленою ішемічною хворобою серця або дилатаційною кардіоміопатією, та зниженою (< 40 %) фракцією викиду лівого шлуночка, серцевою недостатністю ІІ Б за критеріями Стражеска–Василенка, ІІІ — ІV функціонального класу за критеріями Нью‑Йоркської Асоціації серця (NYHA), госпіталізованих з приводу декомпенсації кровообігу. Медіана віку становила 59,5 (54—68) року. Усім пацієнтам проводили загальноклінічне обстеження, визначали рівень креатиніну, азоту сечовини, сечової кислоти, інтерлейкіну‑6, цитруліну в плазмі крові, N‑термінального фрагмента попередника мозкового натрійуретичного пептиду (NT‑proBNP) при госпіталізації та перед випискою, швидкість клубочкової фільтрації (ШКФ) за допомогою рівняння CKD‑EPI. Хворі отримували стандартне лікування. Пацієнтів розділили на дві групи за величиною приросту вмісту креатиніну перед випискою: перша — з ПНФ (зі збільшенням рівня креатиніну ≥ 17,7 мкмоль/л), друга — без ПНФ. Результати та обговорення. У 110 (82 %) пацієнтів не виявлено ПНФ після подолання клінічної декомпенсації, у 24 (18 %) — рівень креатиніну збільшився на 17,7 мкмоль/л або більше, що відповідало зниженню ШКФ ≥ 5 мл/(хв · 1,73 м 2 ). При госпіталізації пацієнти не відрізнялися статистично значущо за віком, частотою коморбідної патології, основними гемодинамічними показниками, рівнем калію в плазмі крові, азоту сечовини, сечової кислоти, NT‑proBNP, величиною ШКФ. Після досягнення еуволемічного стану в пацієнтів з ПНФ відзначено меншу величину систолічного артеріального тиску, вищий рівень азоту сечовини, сечової кислоти, інтерлейкіну‑6 та цитруліну. Для подолання декомпенсації цим особам знадобилося більше часу, майже вдвічі більші курсових та вищі середньодобові дози петльового та калійзберігаючого діуретиків. Пацієнти з ПНФ мали статистично значущо гірший прогноз щодо тривалої виживаності. Висновки. Серед пацієнтів з ХСН та зниженою фракцією викиду лівого шлуночка, госпіталізованих з декомпенсацією кровообігу, ПНФ під час терапії виникло у 18 % випадків. На момент виписки у пацієнтів з ПНФ порівняно з пацієнтами без такої відзначено статистично нижчий рівень систолічного артеріального тиску, більшу тривалість періоду подолання декомпенсації, більші середньодобові дози петльового та калійзберігаючого діуретиків, більший вміст сечової кислоти, азоту сечовини, інтерлейкіну‑6 та цитруліну в плазмі крові. Хворі з декомпенсованою ХСН та ПНФ мали меншу виживаність порівняно із пацієнтами без ПНФ.
{"title":"Clinical characterіstics and survival of hospitalized patients with chronic heart failure and reduced left ventricular ejection fraction depending on dynamics of nitrogen-releasing kidney function during period of overcoming clinical decompensation","authors":"L. Voronkov, G. Dudnik, A. Liashenko, L. Mhitaryan, T. Gavrilenko","doi":"10.30978/HV2018-4-27","DOIUrl":"https://doi.org/10.30978/HV2018-4-27","url":null,"abstract":"Мета роботи — вивчити основні клініко‑гемодинамічні та лабораторні характеристики у госпіталізованих пацієнтів з хронічною серцевою недостатністю (ХСН) залежно від динаміки азотовидільної функції нирок у період подолання декомпенсації та оцінити прогностичне значення погіршення ниркової функції (ПНФ) в цієї категорії пацієнтів. Матеріали і методи. Обстежено 134 пацієнти з ХСН, зумовленою ішемічною хворобою серця або дилатаційною кардіоміопатією, та зниженою (< 40 %) фракцією викиду лівого шлуночка, серцевою недостатністю ІІ Б за критеріями Стражеска–Василенка, ІІІ — ІV функціонального класу за критеріями Нью‑Йоркської Асоціації серця (NYHA), госпіталізованих з приводу декомпенсації кровообігу. Медіана віку становила 59,5 (54—68) року. Усім пацієнтам проводили загальноклінічне обстеження, визначали рівень креатиніну, азоту сечовини, сечової кислоти, інтерлейкіну‑6, цитруліну в плазмі крові, N‑термінального фрагмента попередника мозкового натрійуретичного пептиду (NT‑proBNP) при госпіталізації та перед випискою, швидкість клубочкової фільтрації (ШКФ) за допомогою рівняння CKD‑EPI. Хворі отримували стандартне лікування. Пацієнтів розділили на дві групи за величиною приросту вмісту креатиніну перед випискою: перша — з ПНФ (зі збільшенням рівня креатиніну ≥ 17,7 мкмоль/л), друга — без ПНФ. Результати та обговорення. У 110 (82 %) пацієнтів не виявлено ПНФ після подолання клінічної декомпенсації, у 24 (18 %) — рівень креатиніну збільшився на 17,7 мкмоль/л або більше, що відповідало зниженню ШКФ ≥ 5 мл/(хв · 1,73 м 2 ). При госпіталізації пацієнти не відрізнялися статистично значущо за віком, частотою коморбідної патології, основними гемодинамічними показниками, рівнем калію в плазмі крові, азоту сечовини, сечової кислоти, NT‑proBNP, величиною ШКФ. Після досягнення еуволемічного стану в пацієнтів з ПНФ відзначено меншу величину систолічного артеріального тиску, вищий рівень азоту сечовини, сечової кислоти, інтерлейкіну‑6 та цитруліну. Для подолання декомпенсації цим особам знадобилося більше часу, майже вдвічі більші курсових та вищі середньодобові дози петльового та калійзберігаючого діуретиків. Пацієнти з ПНФ мали статистично значущо гірший прогноз щодо тривалої виживаності. Висновки. Серед пацієнтів з ХСН та зниженою фракцією викиду лівого шлуночка, госпіталізованих з декомпенсацією кровообігу, ПНФ під час терапії виникло у 18 % випадків. На момент виписки у пацієнтів з ПНФ порівняно з пацієнтами без такої відзначено статистично нижчий рівень систолічного артеріального тиску, більшу тривалість періоду подолання декомпенсації, більші середньодобові дози петльового та калійзберігаючого діуретиків, більший вміст сечової кислоти, азоту сечовини, інтерлейкіну‑6 та цитруліну в плазмі крові. Хворі з декомпенсованою ХСН та ПНФ мали меншу виживаність порівняно із пацієнтами без ПНФ.","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85725254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathogenetic justification and clinical significance of using arginine for prevention of critical ischemia of lower extremities and fatal manifestations of multifocal atherosclerosis","authors":"V. Mishalov, V. Chernyak, O. Sopko, D. Dubenko","doi":"10.30978/hv2018-4-79","DOIUrl":"https://doi.org/10.30978/hv2018-4-79","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83688533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Mishalov, V. Cherniak, L. Natrus, B. Koval, V. Holinko, S. O. Makhynia
{"title":"Molecular genetic aspects of early diagnosis and personalized treatment of obliterating atherosclerosis of lower limb arteries","authors":"V. Mishalov, V. Cherniak, L. Natrus, B. Koval, V. Holinko, S. O. Makhynia","doi":"10.30978/HV2018-4-97","DOIUrl":"https://doi.org/10.30978/HV2018-4-97","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73057177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rationale and results of correction of cognitive dysfunction in patients with chronic heart failure and a reduced left ventricular ejection fraction using a combination of meldonium and gamma-butyrobetaine","authors":"L. Voronkov, A. Solonovych, A. Liashenko","doi":"10.30978/hv2018-4-62","DOIUrl":"https://doi.org/10.30978/hv2018-4-62","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89177790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term results of treatment of varycose disease by metod of endovasal laser coagulation","authors":"B. Matviychuk, N. R. Fedchyshyn","doi":"10.30978/hv2018-4-45","DOIUrl":"https://doi.org/10.30978/hv2018-4-45","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87301556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Features of ultrasound changes of veins in case of varicose disease of lower extremities of pregnant and puerperant women","authors":"S. M. Vasyliuk, B. Krysa, I. Dmytriv","doi":"10.30978/HV2018-4-49","DOIUrl":"https://doi.org/10.30978/HV2018-4-49","url":null,"abstract":"","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77559168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Mostovoy, L. Rasputina, D. Didenko, V. Rasputin, I. Mezhiievska, A. Broniuk
The aim — to evaluate the efficacy and safety of addition of a solution containing 4.2 g of arginine hydrochloride and 2.0 g L‑carnitine to standard therapy of patients with acute coronary syndrome (ACS) with ST segment elevation and concomitant type 2 diabetes mellitus (DM) after revascularization through primary coronary intervention (PCI). Materials and methods. The study involved 60 patients (mean age 64.3 ± 1.6 years) with ACS with ST segment elevation of up to 6 hours’ duration and concomitant type 2 DM, who had had urgent coronary angiography and stenting of the infarction‑dependent artery. The patients were divided into two groups: group І — 30 persons to whom standard intravenous infusion was given of a preparation containing 4.2 g of arginine hydrochloride and 2.0 g of L‑carnitine, 100 ml a day for 7 days, and group ІІ — 30 individuals who did not receive additional therapy. A general clinical examination was conducted with an assessment of complaints and anamnesis, objective physical examination data and the results of additional diagnostic methods. The level of troponin I and resolution of ST segment were determined on the 1st, 3rd and 7th days. Results and discussion. Patients in both groups were compared according to the main clinical and anthropometric indices, prescribed drug therapy, features of atherosclerotic damage of coronary artery, duration of ischemic period, troponin I level on the 1st, 3rd and 7th days (all p > 0.05). The value of ST segment elevation at the time of hospitalization in the patients of both groups did not differ significantly: 4.8 ± 0.17 and 4.5 ± 0.15 mm respectively, but on day 3 it was lower in group І (2.37 ± 0.14 mm) compared with group II 3.2 ± 0.17 mm, p = 0.05). In patients of group I, unlike such of group II, there was a significant decrease in the level of aspartate aminotransferase and alanine aminotransferase on day 7. The decrease in group I was more pronounced than in group II (p = 0.048 and p = 0.032, respectively). Conclusions. The addition of amino acids complexes (4.2g of arginine hydrochloride and 2.0 g of L‑carnitine) to drug therapy of patients with ACS with ST segment elevation and concomitant DM type 2 after myocardial revascularization, contributes to a rapid decrease in the level of troponin I and reduction in ST segment elevation and is not accompanied by side effects.
目的:评价急性冠脉综合征(ACS) ST段抬高合并2型糖尿病(DM)患者经初级冠状动脉介入治疗(PCI)血运重建术后，加入含有4.2 g盐酸精氨酸和2.0 g左旋肉碱的溶液进行标准治疗的疗效和安全性。材料和方法。该研究涉及60例ACS患者(平均年龄64.3±1.6岁)，ST段抬高持续时间长达6小时，并伴有2型糖尿病，这些患者曾接受紧急冠状动脉造影和梗死依赖动脉支架置入术。患者被分为两组:І组- 30人给予标准静脉输注含有4.2 g盐酸精氨酸和2.0 g左旋肉碱的制剂，每天100毫升，持续7天;ІІ组- 30人不接受额外治疗。进行一般临床检查，评估主诉和记忆，客观体格检查资料和其他诊断方法的结果。分别于第1、3、7天测定肌钙蛋白I水平和ST段分辨率。结果和讨论。比较两组患者的主要临床及人体测量指标、处方药物治疗、冠状动脉粥样硬化损伤特征、缺血时间、第1、3、7天肌钙蛋白I水平(均p > 0.05)。两组患者入院时ST段抬高值无显著差异，分别为4.8±0.17 mm和4.5±0.15 mm，但第3天І组ST段抬高值(2.37±0.14 mm)低于ⅱ组(3.2±0.17 mm, p = 0.05)。I组患者与II组患者不同，第7天天冬氨酸转氨酶和丙氨酸转氨酶水平明显下降。I组较II组下降更明显(p = 0.048, p = 0.032)。结论。在心肌血运重建术后伴有ST段抬高的ACS患者药物治疗中加入氨基酸复合物(4.2g盐酸精氨酸和2.0 g左旋肉碱)，可使肌钙蛋白I水平迅速降低，ST段抬高降低，且无副作用。
{"title":"Acute myocardial infarction in patients with diabetes mellitus: possibility and expediency of cardioprotection","authors":"Y. Mostovoy, L. Rasputina, D. Didenko, V. Rasputin, I. Mezhiievska, A. Broniuk","doi":"10.30978/HV2018-4-34","DOIUrl":"https://doi.org/10.30978/HV2018-4-34","url":null,"abstract":"The aim — to evaluate the efficacy and safety of addition of a solution containing 4.2 g of arginine hydrochloride and 2.0 g L‑carnitine to standard therapy of patients with acute coronary syndrome (ACS) with ST segment elevation and concomitant type 2 diabetes mellitus (DM) after revascularization through primary coronary intervention (PCI). Materials and methods. The study involved 60 patients (mean age 64.3 ± 1.6 years) with ACS with ST segment elevation of up to 6 hours’ duration and concomitant type 2 DM, who had had urgent coronary angiography and stenting of the infarction‑dependent artery. The patients were divided into two groups: group І — 30 persons to whom standard intravenous infusion was given of a preparation containing 4.2 g of arginine hydrochloride and 2.0 g of L‑carnitine, 100 ml a day for 7 days, and group ІІ — 30 individuals who did not receive additional therapy. A general clinical examination was conducted with an assessment of complaints and anamnesis, objective physical examination data and the results of additional diagnostic methods. The level of troponin I and resolution of ST segment were determined on the 1st, 3rd and 7th days. Results and discussion. Patients in both groups were compared according to the main clinical and anthropometric indices, prescribed drug therapy, features of atherosclerotic damage of coronary artery, duration of ischemic period, troponin I level on the 1st, 3rd and 7th days (all p > 0.05). The value of ST segment elevation at the time of hospitalization in the patients of both groups did not differ significantly: 4.8 ± 0.17 and 4.5 ± 0.15 mm respectively, but on day 3 it was lower in group І (2.37 ± 0.14 mm) compared with group II 3.2 ± 0.17 mm, p = 0.05). In patients of group I, unlike such of group II, there was a significant decrease in the level of aspartate aminotransferase and alanine aminotransferase on day 7. The decrease in group I was more pronounced than in group II (p = 0.048 and p = 0.032, respectively). Conclusions. The addition of amino acids complexes (4.2g of arginine hydrochloride and 2.0 g of L‑carnitine) to drug therapy of patients with ACS with ST segment elevation and concomitant DM type 2 after myocardial revascularization, contributes to a rapid decrease in the level of troponin I and reduction in ST segment elevation and is not accompanied by side effects.","PeriodicalId":23425,"journal":{"name":"UMJ Heart & Vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84861683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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