Online ISSN: 3007-0244,
Print ISSN:  2410-4280
NEW ASPECTS OF TREATMENT OF CHRONIC HEART FAILURE: FOCUS ON ANTAGONISTS OF MINERALOCORTICOID RECEPTORS

Introduction. The article presents evidence of the efficacy and safety of the use of receptor blockers aldosterone, which were obtained in the implementation of several randomized clinical trials. Presents the first experience of application of the selective antagonist of mineralocorticoid receptors in clinical practice.

The aim of the study was to assess the effect of the antagonist of mineralocorticoid receptors of eplerenone on the functional state of patients with heart failure, dynamics of the LV ejection fraction and the concentration of brain natriuretic peptide in the blood.

Materials and methods: study design – uncontrolled clinical trial. We selected 30 patients hospitalized in the cardiology department № 2 emergency Hospital clinic of chronic heart failure in the decompensation stage. After careful analysis, previous therapy, the patient made adjustments according to the latest recommendations on the appointment of the drug eplerenone in a dosage of 25 mg/day, once, with subsequent titration up to 50 mg/day. Statistical processing of the actual material was carried out using the software packages SPSS version 20.0. The commonly used indicators were calculated: the arithmetic mean (M), median (Me), mode (M0), 95% confidence interval (CI 95). The Student's coefficient (t) was calculated to justify the reliability of differences in the variables studied. Differences between the compared variables at p <0.05 were considered reliable.

Results and conclusions: the study included 21 men (70%) and 9 women (30%) the average age of the patients was 57,9 ± 3,3 years. All patients had a detailed clinical picture of heart failure, functional class NYHA of CHF were III (56%) and IV (44%). In the primary analysis of the data of echocardiography, the average left ventricular ejection fraction was 37,5 ± 2,7 per cent. Brain natriuretic peptide (BNP) were determined selectively, examinees was average BNP – 475,7 ± 3,9 pg/ml. At the control examination, the average LVEF was 45,4 ± 1,5%, and the average creatinine and potassium was 108 ± 2,1 mcmol/l and 5,2 ± 0,9 mmol/l respectively.

Conclusion: AMS is an obligatory component of therapy of CHF. Eplerenone showed its effectiveness in improving functional status, increasing LV EF in patients with CHF decompensation.

Key words: heart failure, antagonist of mineralocorticoid receptors, ejection fraction.

 

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Category of articles: Original article

Bibliography link

Karazhanova L.K., Nasymbekov M.R., Khaidarova O.V., Orekhov A.Yu., Ospanova M.M. New aspects of treatment of chronic heart failure: focus on antagonists of mineralocorticoid receptors. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 6, pp. 88-100.


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