Work number - M 36 FILED
Author:Fesenko O. V.
Presented by State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”.
Development of recommendations for the improvement of diagnosing and treatment of chronic ischemic heart disease (IHD) with diastolic dysfunction of the myocardium in patients with chronic obstructive pulmonary disease (COPD) was an aim of our study. The evaluation and comparison of the left heart structure and function, arrhythmias, imbalance of the autonomic activity during 24-hour ECG monitoring had been performed. The presence of diastolic dysfunction was established in 75% of patients with IHD and COPD. The grade of the dysfunction was higher in men with concomitant COPD. In patients with IHD and concurrent COPD the increase of the sympathetic, as well as the decrease of parasympathetic activity had been registered. These changes lead to the increase of the ventricular and supraventricular arrhythmias, contributes to the increase of incidence of the ischemic ST-segment depression. Administering of nebivolol and ivabradine provides the improvement of the diastolic function. The decrease of ventricular extrasystoles with the administration of nebivolol had been shown. Administering of nebivolol and ivabradine provides a due antiischemic effect. The use of nebivolol results in the decline of sympathetic activity, ivabradine provides the increase of parasympathetic activity. The administration of nebivolol and ivabradine did not worsen respiratory status and is safe in patients with IHD and COPD.
Developed and implemented the use of heart rate variability during 24-hour ECG monitoring for predicting ventricular arrhythmias and episodes of silent myocardial ischemia, and the use of nebivolol for correction of autonomic imbalance, reducing the number of arrhythmias and ischemic events in patients with IHD and COPD. Results of the study were put into practice at the Cardiology Department of the regional hospital in the city of Dnepropetrovsk, Kirovograd, and the Department of Noncoronary Myocardial Diseases in the city of Krivoy Rog.
The world level suggests the presentation of the results of the research during poster discussion sessions at the congresses of the European Respiratory Society in 2014 in Munich and in 2015 in Amsterdam.
Results of the research are reflected in 3 articles and 5abstracts in national journals and theses in 2 issues of the European Respiratory Journal. Novelty and competitive solutions are protected by 3 copyright certificates.
The total number of publications of the author - 11.