OPTIMIZATION OF VENTRICULAR ARRHYTHMIAS DIAGNOSTICS: ASSESSING THE DYNAMICS OF THE REGULATORY-ADAPTIVE STATUS
Abstract
Introduction. Criteria for the effectiveness of therapy for ventricular arrhythmias (VA) take into account only the antiarrhythmic effect of pharmacological agents, which does not correspond to the modern personalized approach in medicine. Сurrently beta-blockers (BB) have the greatest evidence base in the treatment of VA. Their hypotensive and antianginal properties have been sufficiently studied. However, there is evidence of a possible negative impact of BB on the regulatory-adaptive status (RAS), characterizing the global functional state, ability to regulate and adapt. Thus, the issues of optimizing diagnostics in patients with VA are relevant. Aim. To study the effect of β-blockers on the parameters of the cardiorespiratory synchronism (CRS) test in patients with VA. Materials and methods. The study included 120 patients with VА and essential hypertension (ЕH) or its combination with coronary heart disease (CHD), randomized into three groups for the treatment of ВВ with different pharmacochemical properties: bisoprolol, nebivolol and sotalol. As part of combination therapy, an angiotensin-converting enzyme inhibitor, lisinopril, was prescribed, and if indicated, a disaggregant, acetylsalicylic acid, and a lipid-lowering drug, atorvastatin. Initially and after 24 weeks of therapy, the following were performed: CRS test, daily monitoring of the electrocardiogram and blood pressure. Results. In all three groups of patients, comparable hypotensive and antiarrhythmic effects were recorded. When nebivolol was prescribed as part of combination therapy in patients with VA against the background of stage III EH or its combination with CHD, an increase in the synchronization range and RAS index was observed, in contrast to bisoprolol and sotalol. Conclusion. In patients with VA and EH or its combination with CHD, the CRS test makes it possible to determine the optimal combination therapy option that has the most positive effect on the functional state and RAS index.
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