CHANGES IN CLINICAL MANIFESTATION OF CONGESTIVE HEART FAILURE AT THE BACKGROUND OF REGULAR RAMIPRIL INTAKE

Aim. To study dynamics in clinical signs of congestive heart failure (CHF) while taking ramipril regularly.

Material and methods. Totally 135 patients studied (124 men, 11 women), mean age 60±8,7, with Q-MI in anamnesis of different location 3 years ago, with clinical signs of CHF III NYHA. One year after hospitalization the adherence to therapy was evaluated by Moricki-Greene test. The parameters studied: life quality, signs of CHF, exercise tolerance, morphology and systolic and diastolic function of LV and RV, respiratory system parameters, and of kidneys.

Results. By the Moricki-Greene test results all patients were divided into 2 groups: I group — non-adherent patients, II — compliant. In 1 year of follow-up in those of II group the positive dynamic observed. Functional class changed to II, clinical signs of CHF decreased, life quality improved, exercise tolerance increased, intra- and transventricular dyssynchrony decreased, dyspnea regressed from 3 to 2 by Modified Medical Research Council Scale, the NT-proBNP concentration, sudden death risk, BP and HR stabilized at normal values, microalbuminuria decreased, GFR increased. Also we marked the regress of LV and RV volumes, increase of EF, improvement of diastolic function, increase of heart rate variability by the decrease of sympathetic activity.

Conclusion. Clinical signs of CHF after Q-MI with III NYHA are presupposed by morpho-functional changes in the heart, cardiopulmonary and cardiorenal continuum, that have common engine for progressing and showing worse outcomes. Therapy adherence with the usage of ramipril makes possible CHF compensation and decreases the chance for exacerbation and progressing of comorbidity. 

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