Clinical and hemodynamic efficacy of selective beta-blocker bisoprolol and cytoprotector trimetazidine in the treatment of chronic cardiac failure in patients with ischemic heart disease

摘要

AIM: To assess the effect of a long-term (6 months) treatment with selective beta-blocker bisoprolol, cytoprotector trimetazidine and their combination on the clinical course, left ventricular morphofunctional parameters and quality of life of patients with ischemic heart disease (IHD) with chronic heart failure (CHF) functional class III-IV. MATERIAL AND METHODS: A total of 71 IHD patients with CHF (FC III-IV) entered the study. In group 1 basic therapy was combined with bisoprolol, in group 2--with trimetazidine, in group 3--with bisoprolol + trimetazidine. The initial dose of bisoprolol was 1.25 mg with subsequent dose titration to individually tolerated. Trimetazidine was given in a dose 20 mg 3 times a day. Clinical tests and echocardiography parameters were assessed monthly. RESULTS: CHF functional class decreased in all the groups. End diastolic and systolic volumes of the left ventricle reduced, while ejection fraction increased. The best treatment results were achieved in combination of bisoprolol with trimetazidine (LV EF increased by 42.6%, while Ve/Va decreased by 59%). CONCLUSION: Clinicohemodynamic benefit obtained after long-term administration of bisoprolol, trimetazidine and their combination in IHD patients with CHF (Fc III-IV) justifies inclusion of these drugs as monotherapy and combined treatment of CHF in IHD.