Metabolic neuroprotection in patient with chronic heart failure: a case report and study results

Cardiovascular diseases (CVD) are the leading cause of global mortality. The relative burden of acute forms of coronary heart disease (CHD) is gradually decreasing in the industrially developed countries, while the prevalence of chronic heart failure (CHF) and the number of hospitalizations of patients with CHF, on the contrary, has demonstrated an upward trend over the last decades. This retrospective analysis was performed to evaluate the data of patients with CHF decompensation. In such patients, cardiogenic encephalopathy (CE) was found in 43.4% of cases. A higher frequency and longer duration of hospitalizations was observed in the group of patients with CE. Also, in patients with CE the mortality rate within two years from the date of index hospitalization was twice as high as in patients without CE. For intensifying the major therapeutic options in the treatment of CHF patients with CE, it is feasible to consider the addition of numerous medications with supplementary pharmacological effects which may potentiate the efficacy of cardiotropic therapy. Among metabolically active drugs, an emphasis should be made on myocardial cytoprotectors. The results of several studies have provided persuasive data supporting the use of cytoprotectors in routine cardiological practice. This article describes a clinical case of using ethylmethylhydroxypyridine succinate for the treatment of an elderly patient with cardiogenic encephalopathy (CE) and presents the data proving the efficacy of this drug as a part of the combined symptomatic and pathogenetic therapy administered to patients with chronic cerebral ischemia amid CHD and CHF. KEYWORDS: cardiovascular diseases, ischemic heart disease, chronic heart failure, cardiogenic encephalopathy, cytoprotection, ethylmethylhydroxypyridine succinate, cardiotropic therapy. FOR CITATION: Reznik E.V., Alieva A.M., Ushakova N.A., Krupnova E.S. Metabolic neuroprotection in patient with chronic heart failure: a case report and study results. Russian Medical Inquiry. 2023;7(1):49–55 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-49-55.