Prevention and treatment of chronic heart failure. Possibilities of cytoprotective therapy

Announcement:

This video lecture is devoted to one of the most pressing issues in modern cardiology — prevention and treatment of chronic heart failure (CHF). The expert — head of the Department of Internal Medicine No. 2 of the Federal State Budgetary Educational Institution of Higher Education Kazan State Medical University of the Ministry of Health of Russia Vadim Petrovich Mikhin — examines in detail why CHF is the cause of more than 71% of deaths from diseases of the circulatory system, and offers practical solutions to improve the prognosis in such patients.

In this video you will find answers to key questions:

• Why is the problem of CHF so acute today? Saving patients from acute myocardial infarction and untreated arterial hypertension leads to the fact that specialists often deal with their consequences: myocardial remodeling, dystrophy, hypoxia and activation of free-radical oxidation.
• What tool do we have in our arsenal besides standard therapy? The role of cytoprotective therapy is considered in detail - a strategy aimed at preserving the life of a cell, restoring its energy exchange and functional activity.
• What are the differences between the main cytoprotectors? The speaker provides a clear and understandable analysis of the mechanisms of action:
• Trimetazidine - blocks beta-oxidation of fatty acids, which requires a lot of oxygen;
• Meldonium - inhibits the entry of fatty acids into the mitochondria;
• Ethylmethylhydroxypyridine succinate (Mexidol) - stimulates the Krebs cycle, providing energy production with priority for glucose oxidation, which saves oxygen.
• What evidence of effectiveness exists? The results of Russian studies (including the latest from 2021) are presented, demonstrating that adding Mexidol to standard CHF therapy:
• Increases tolerance to physical activity (6-minute walk test);
• Improves diastolic function and myocardial adaptation to stress;
• Reduces NT-proBNP levels, a key biomarker of heart failure severity;
• Reduces markers of oxidative stress (MDA) and systemic inflammation (CRP);
• Reliably improves the quality of life of patients according to specialized questionnaires.

This material is a ready-made guide to action for doctors who seek not only to reduce symptoms, but to influence the pathogenetic mechanisms of CHF development, protect the myocardium and significantly improve the prognosis and life of their patients.