TREATMENT OF EARLY STAGES OF HEART FAILURE

Abstract

We performed a complex study of central, cardiac and peripheral regional hemodynamics (PRH), neurohumoral activity, tolerance to dosed physical stress, as wells life quality evaluation and comparative efficacy of long-term (12 months) sole7 treatment with enalapril, atenolol, nitrosorbid and verapamil in 108 patients with a history of MI and mild heart failure, with a sinus rhythm at the baseline. We have shown enalapril to influence beneficially LV systolic and diastolic function, central hemodynamics, thromboxan-prostacyclin misbalance, enhanced PRH, decreased plasma norepinephrin and aldosterone activities by the end of the 1st week. Atenolol increased LV systolic and diastolic function by the end of the 2-3th month of treatment, in a stable manner decreasing HR, norepinephrin concentration, increased tolerance to dosed physical stress and enhanced PRH moderately. Nitrosorbid influenced central and cardiac hemodynamics in a moderate way, had no effect on neurohumoral activity, LV diastolic function; the studied values by the end of the 3-4th month were comparable with those at baseline. Verapamil had no influence on LV systolic and diastolic function, enhanced PRH, mostly in the arterial part of the vasculature, increased plasma aldosterone activity. Enalapril and atenolol are the drugs of choice in treating mild heart failure in patients with a history of MI as they exert beneficial effect on most of the pathogenetic aspects of heart failure and improve life quality.