Place of publication:
cardiology and cardiovascular surgery, 2021, T. 14, No. 1
Summary:
Purpose of the study. To study the effect of Mexidol on the functional state of the myocardium, the level of cerebral sodium peptide (NT-PROBNP), the tolerance of physical activity, the quality of life, the severity of oxidative stress, inflammatory reaction and endothelial dysfunction in patients with chronic brain ischemia and chronic heart failure ( ) II - III functional class (FC) according to the Nyha classification with the sequential intravenous and oral introduction of the drug Mexidol for 13 weeks against the background of standard basic therapy. Material and methods. The study included 44 patients with chemical and heart failure II - III FC according to Nyha. The average age was 65.5 ± 11.8 years (75% of men); 21 The patient was in the basic therapy group with the additional purpose of Mexidol, 23 patients in the basic therapy group. Initially, on the 7th day and at the 13th week, echocardiographic indicators, the level of NT-PROBNP, tolerance of physical activity (test with 6-minute walking, T6MX), assessment of the clinical state of the patient on the shock scale (modification V.Yu. Mareeva), oxidative stress parameters (level of little dyilladehyde (MDA) and the activity of superoxidsmutase (SOD)), inflammatory reaction (S-reactive protein level, tumor necrosis factor (FI-α), as well as the content of homocysthanes and level of cystatin S. initially and at the end of the study evaluated the quality of life according to the results of the Minnesotsky questionnaire of the quality of life of patients (minnesota living with Heart Failure Questionnaire, Mlhfq) and the Kansas Cardiopathy Cardiopathy CCCQ ). Results. In patients in the Mexidol+Basic therapy group, a more pronounced improvement in the quality of life, a higher increase in the results of T6Mx, a more pronounced improvement of the clinical state on the shock scale, a reliable decrease in the indicators of the finis-diastolic and endolar size of the LV, and also reliably significantly have been revealed. A more pronounced decrease in the level of NT-PROBNP on the 7th day and after 13 weeks of therapy compared to the basic therapy group. The use of Mexidol, in addition to basic therapy, led to a decrease in the concentration of MDA and an increase in the activity of SOD on the 7th day and after 13 weeks of observation. A reliable decrease in the level of CRC and FINED α was revealed both on the 7th day and 13 weeks of observation against the background of additional use of Mexidol. A slowdown in the increase in homocysteine in the group of therapy with Mexidol was revealed. There were no reliable differences in the indicators of cystatin with between groups. Conclusion. Mexidol, when adding to the basic therapy of patients with chemical and heart failure II - III, FC has a beneficial effect on the quality of life, functional status, improves the clinical state, intracidian hemodynamics, has reliable antioxidant activity, reduces the severity of the inflammatory reaction, slows down the increase in homocysteine, and does not provide influences on the function of the kidneys (cystatin C). Keywords: chronic brain ischemia, heart failure, quality of life, cognitive status, ethylmethylhydroxypyridine succinate, mexidol, oxidative stress, inflammation, endothelial dysfunction.