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

Announcement:

This video lecture focuses on one of the most pressing issues in modern cardiology: the prevention and treatment of chronic heart failure (CHF). Vadim Petrovich Mikhin , examines in detail why CHF accounts for over 71% of deaths from circulatory diseases and offers practical solutions for improving the prognosis for these patients.

In this video you will find answers to key questions:

• Why is the problem of CHF so pressing today? Treating patients after acute myocardial infarction and untreated hypertension means that specialists are increasingly dealing with their consequences: myocardial remodeling, dystrophy, hypoxia, and activation of free radical oxidation.
• What tools do we have in our arsenal beyond standard therapy? The role of cytoprotective therapy—a strategy aimed at preserving cell life, restoring energy metabolism, and restoring functional activity—is examined in detail.
• What are the differences between the main cytoprotectors? The speaker provides a clear and understandable analysis of their 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 exists for its effectiveness? Results from Russian studies (including a recent 2021 study) 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.