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The influence of the additional usage of L-arginine on the factors of vasodilation and the clinical data, complicated with cardiac decompensation with reduced and preserved fracture of the left ventricle that patients with stable coronary heart disease ha

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Author: 
Denesyuk, V. and Muzyka, N.
Abstract: 

Introduction: The endothelial dysfunction is one of the most difficult forms of vascular malformation. The dominant ferment, that provides the synthesis NO in the blood-making stream, is the endothelial NO-synthase, that is produced on the endothelium and plays an important role in the basic level NO support (Erdei et al., 2014; Cwynar et al., 2015). It is proved that the reduction of the activity еNOS leads to the decrement NO production and is one of the key elements of pathogenesis coronary heart disease (CHD) (Zaremba, 2012).
The aim of the research: to estimate the influence of the additional usage of L-arginine hydrochloride on the factors of vasodilation and the clinical data, complicated with cardiac decompensation with impaired and reserved ejection fraction of the left ventricle that patients with stable CHD have.
Materials and methods: To achieve the aim of the research the full medical observation with 40 CHD patients was held (28 men and 12 women, the average age is 68,80±0,90 years), who were in the heart disease department for the patients with rhythm disturbance Vinnytsya regional cardiovasculare pathology centre (Ukraine).
Results: After the comparing the levels of the vasodilatation factors of the healthy people (the control group) with the information that the patients with the stable CHD, complicated with HF with impaired and reserved LV EF, the certain difference between the markers of the levels еNOS, nitrites and nitrates in the blood serum (p<0.01), that deposes the increasing of the endothelial dysfunction. Similar results were obtained in patients 2 groups. , the patients with the decreasing LV EF and the progressing HF had the certain decreasing of the level еNOS, nitrites and the nitrates in the blood serum, that deposes the negative difficulties of the endothelial function. The analogical information got after the standard complex therapy HF during 10 days with the additional usage L-arginine hydrochloride at a dose 100 ml 4,2 % intravenous, the patients of the first group have the following level еNOS 664,80±85,68 pg/ml, the patients of the second group – 837,81±49,98 pg/ml (p<0.01), that deposes the positive effect of the additional usage of L-arginine hydrochloride. After the complex standard treatment during 10 days tolerance to the physical work in the patients І and ІІ groups increased. The results of the research proves that the patients with the stable CHD, complicated with HF with decreased and reserved LV EF after the usage of “Tivortin” 100 ml 4,2 % intravenous during 10 days influenced the increasemnet of FC HF.
Conclusions: After the comparing the levels of the vasodilatation factors of the healthy people with the information that the patients with the stable CHD, complicated with cardiac decompensation with impaired and reserved fracture of the left ventricle, the certain difference between the markers of the levels еNOS, nitrites and nitrates in the blood serum, that deposes the increasing of the endothelial dysfunction. After the treatment heart failure during 10 days with the additional usage L-arginine hydrochloride at a dose of 100 ml 4,2 % intravenous, the level of the vasodilatation increased, particucar the endothelial NO-synthase not only in the patients with stable CHD, with impaired and reserved fracture of the left ventricle. The results of the research proves that the increasing levels of vasodilators in the blood serum influences the decreasing of the clinical symptoms heart failure, that deposes the effectiveness of the following therapy.

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