EFFICIENCY OF COMBINATIONS OF CALCIUM ANTAGONIST WITH RENIN-ANGIOTENSINALDOSTERONE SYSTEM BLOCKERS IN PATIENTS WITH CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
Objective. To estimate changes in clinical status, quality of life, structural and functional myocardial parameters in patients with early stages of chronic heart failure with preserved ejection fraction (EF) with the combination treatment by calcium antagonist and renin-angiotensin-aldosterone system blocker (angiotensin converting enzyme inhibitor or angiotensin II receptor blocker). Design and methods. We examined 104 patients with chronic heart failure with preserved EF (EF > 50 %). All patients were divided into three groups: the first group (n = 37) was treated by combination of amlodipin (average dose 6,9 ± 2,1 mg/day) and perindopril arginine (average dose 12,3 ± 2,9 mg/day), the second group (n = 37) — by combination of S (-) amlodipin (average dose 3,2 ± 1,1 mg/day) and valsartan (average dose 130,8 ± 38,8 mg/day), the third control group (n = 30) — by standard therapy of chronic heart failure. All patients underwent full examination at baseline and in 12 weeks, including clinical status, the level of N-terminal brain natriuretic propeptide, quality of life by Minnesota questionnaire, 6-minute walk test, electrocardiogram monitoring, and heart ultrasound. Results and conclusions. Decrease in clinical manifestations and symptoms of chronic heart failure, improvement of exercise tolerance, increase in quality of life, regress of myocardial hypertrophy were found in all groups. Increased exercise tolerance and reduction in the degree of myocardial hypertrophy was the most expressed in the first group (calcium antagonist + angiotensin II receptor blocker), improvement of diastolic function — in the second group (calcium antagonist + angiotensin converting enzyme inhibitor).