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Central Asian Journal of Medicine

Abstract

Aim of the study: to evaluate the effectiveness of Liverin's influence on the processes of fibrosis of the heart and target organs, including the liver, in different hemodynamic phenotypes of chronic heart failure. Materials and methods: The effect of the drug Liverin on the heart and target organs, including the liver, was studied in 123 patients with CHF with various types of left ventricular ejection fraction. The patients were divided into 2 groups, the 1st group included 64 patients, the 2nd group - 59 patients with CHF. Patients of the 1st group with CHF against the background of standard treatment received the drug Liverin at a dose of 600 mg - 2 ml intravenously for 7 days, after which this drug was prescribed 2 capsules 3 times a day for 3 months. Patients in Group 2 received only standard treatment. After the therapy, 3 months later, the function of the right chambers of heart were assessed using echocardiography and the degree of liver fibrosis was assessed by liver elastography and the levels of galectin-3 and aldosterone in the blood serum were determined. Results: Observation showed that in patients of the 1st group, against the background of the treatment (standard treatment + liverin), central hemodynamic indices improved, there was a significant regression of left ventricular hypertrophy, mean liver density (MLD) and indicators on the Metavir scale (F) decreased, the levels of galectin - 3 and aldosterone in the blood serum decreased significantly, which reflect the activity of fibrotic processes in the body (p <0.001). And also there was an improvement in the clinical and functional state of patients against the background of the treatment, which was reflected by a significant decrease in the diameter of the inferior vena cava and signs of its collapse during a deep breath, as well as signs of pulmonary hypertension in this patient. Patients of group 2 showed a partial improvement in clinical and functional state against the background of blockade of neurohormonal activation, but there was no statistically significant dynamics of indicators of MLD, F, pressure and volume of the right heart. Conclusions: For the early diagnosis of fibrosis of the heart and liver in patients with various hemodynamic types of CHF, it is necessary to perform echocardiography and elastography of the liver and determine the level of galectin-3 and aldosterone in the blood serum. The use of liverin as part of standard therapy for CHF reduces the processes of fibrosis of the heart and liver, leads to regression of cardiac remodeling, as well as an improvement in the clinical and functional state of patients.

First Page

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Last Page

65

References

1. Ather S, Chan W, Bozkurt B, Aguilar D, Ramasubbu K, Zachariah AA et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction // J Am Coll Cardiol. – 2012. – Vol. 59 (11). P. 998 - 1005. DOI:10.1016/j. jacc. 2011.11.040. 2. Belenkov Yu. N. Mareev V. Yu., Ageev F. T. Xronicheskaya serdechnaya nedostatochnost': izbrannie leksii po kardiologii. – M.: GEOTAR–Media, 2006. – 428 s. 3. Braunstein JB, Anderson GF, Gerstenblith G, Weller W, Niefeld M, Herbert R et al. Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure // J Am Coll Cardiol. - 2003. Vol. 42 (7). - P. 1226 - 33. 4. Ding Cuangsheng. Anti – arrhythmia agents in traditional Chinese medicines // Abstracts of Chinese Medicine. – 1987. – Vol. 1 (2). – P. 287 – 308. 5. Fox K., Ford I., Steg P.G., Tardif J.C., Tendera M., Ferrari R. SIGNIFY Investigators. Ivabradine in stable coronary artery disease without clinical heart failure // N Engl J Med. – 2014. – Vol. 371. – P. 1091 - 1099. doi: 10.1056/NEJMoa1406430. 6. Fox K., Ford I., Steg P.G., Tendera M., Ferrari R. BEAUTIFUL Investigators. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial // Lancet. – 2008. – Vol. 372 (9641). – P. 807 - 816. doi: 10.1016/S0140-6736(08)61170-8. 7. Fox K., Ford I., Steg P.G., Tendera M., Robertson M., Ferrari R. BEAUTIFUL investigators. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial // Lancet. – 2008. – Vol. 372. – P. 817 - 821. doi: 10.1016/S0140-6736(08)61171-X. 8. Gadaev A.G., Kurbonov A.K. Surunkali yurak yetishmovchiligi va miokardial fibroz. – Monografiya. – Toshkent. – 2020. – 145b. 9. Kjekshus J, Apetrei E, Barrios V, Böhm M, Cleland JGF, Cornel JH et al. Rosuvastatin in older patients with systolic heart failure // New England Journal of Medicine. – 2007. – Vol. 357 (22). – P. 2248 - 61. DOI:10.1056/NEJMoa0706201. 10. Kurbonov A.K. Rol' fibroznix prosessov pri xronicheskoy serdechnoy nedostatochnosti i optimizasii yeyo lecheniya. //Avtoref. dis... d-ra filosofii po med. nauk. 14.00.06. - Tashkent, 2018. - 51 s. 11. Lee H.Y., Baek S.H. Optimal Use of Beta-Blockers for Congestive Heart Failure //Circ J. – 2016. – Vol. 80 – P. 565 – 571. 12. Mancini D. New methodologies to accurately assess circulating active transforming growth factor-β1 levels: implications for evaluating heart failure and the impact of left ventricular assist devices / D. Mancini, J. Monteagudo, M. Suárez-Fariñas, J. Bander, R. Varshney, J. Gonzalez, B. S. Coller, J. Ahamed // Transl Res. – 2018. – Vol. 192. - P. 15-29. 13. Mareev V.Yu., Ageev F.T., Arutyunov G.P. Nasional'nie rekomendasii OSSN, RKO i RNMOT po diagnostike i lecheniyu XSN (chetvertiy peresmotr) // Jurnal Serdechnaya nedostatochnost'. - 2013. - Tom. 14. № 7. - S. 379-472. 14. Mareev V.Yu., Fomin I.V., Ageev F.T. i dr. Klinicheskie rekomendasii OSSN – RKO – RNMOT. Serdechnaya nedostatochnost': xronicheskaya (XSN) i ostraya dekompensirovannaya (ODSN). Diagnostika, profilaktika i lechenie // Kardiologiya. – 2018. – Tom- 58.(№6). – S. 8 – 158 15. Mareev V.Yu., Fomin V.Yu., Ageev F.T. i dr. Klinicheskie rekomendasii. Xronicheskaya serdechnaya nedostatochnost' (XSN) // Jurnal Serdechnaya Nedostatochnost'. – 2017. – Tom. 18, № 1. – S. 3 - 40. 16. Millonig G, Friedrich S, Adolf S, Fonouni H, Golriz M, Mehrabi A et al. Liver stiffness is directly influenced by central venous pressure // Journal of Hepatology. - 2010. - Vol. 52 (2). - P. 206 - 10. DOI:10.1016/j. jhep. 2009.11.018. 17. Nishi H, Toda K, Miyagawa S, Yoshikawa Y, Fukushima S, Kawamura M et al. Novel Method of Evaluating Liver Stiffness Using Transient Elastography to Evaluate Perioperative Status in Severe Heart Failure // Circulation Journal. - 2015. - Vol. 79 (2). - P. 391 - 7. DOI:10.1253 / circj. CJ-14- 0929. 18. Niu Kuizhi. Pharmacology and clinical application of sophora flavescentis // International Journal of Oreintal Medicine. – 1997. – Vol. 22 (1). – P. 75 – 81. 19. Podzolkov V.I., Tarzimanova A.I. Telmisartan v lechenii gipertenzivnix pasientov. Terapevticheskiy arxiv 2017;89 (6):110–113). 20. Rienstra M., Damman K., Mulder B.A. et al. //Beta-blockers and outcome in heart failure and atrial fibrillation: a meta-analysis. JACC Heart Fail 2013.Vol. 1 - P. 21 - 28. 21. Shavazi N. M., Rustamov M.R., Khamrayev Kh.T. et al. Efficacy of Liverin in the treatment of chronic hepatitis B in children // Medical sciences. - 2019. - C. 87 – 90. 22. Sitnikova M.Yu., Lelyavina T.A., Shlyaxto Ye.V., Vologdina I.V. Osobennosti kliniki, diagnostiki prognoza xronicheskoy serdechnoy nedostatochnosti u gospitalizirovannix pasientov starcheskogo vozrasta // Jurnal Serdechnaya Nedostatochnost'. – 2006. Tom. 7 (2 (36)). – S. 85 - 7. 23. Soy L. G. Sitokini i xronicheskaya serdechnaya nedostatochnost' / L. G. Soy // Vestnik Kirgizsko Rossiyskogo Slavyanskogo universiteta. - 2017. - T. 17, № 7. - S. 72 - 75. 24. Sun Jing., Zhao Jonghua et al. Combined therapeutic effect of Oxymatrine on a mouse model infected with a new type of coronavirus // Pharmacollogy. – 2020. – Vol.55 (3). – P. 366. 25. Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study // The Lancet. - 2010. - Vol. 376 (9744). - P. 875 - 85. DOI:10.1016/S0140–6736 (10) 61198 - 1. 26. Taniguchi T, Ohtani T, Kioka H, Tsukamoto Y, Onishi T, Nakamoto K et al. Liver Stiffness Reflecting Right-Sided Filling Pressure Can Predict Adverse Outcomes in Patients With Heart Failure // JACC: Cardiovascular Imaging [Интернет]. 2018; DOI:10.1016/j. jcmg. 2017.10.022 27. Tardif J.C., Ford I., Tendera M., Bourassa M.G., Fox K. INITIATIVE Investigators. Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina // Eur Heart J. – 2005. Vol. 26 (23). - P. 2529 - 2536. doi: 10.1093 / eurheartj / ehi586. 28. Tardif J.C., Ponikowski P., Kahan T., ASSOCIATE Study Investigators. Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta - blocker therapy: a 4 - month, randomized, placebo - controlled trial // Eur Heart J. - 2009 - Vol. (5). - P. 540 - 548. doi: 10. 1093 / eurheartj / ehn 571. 29. Torp-Pedersen C, Poole-Wilson PA, Swedberg K, Cleland JGF, Di Lenarda A, Hanrath P et al. Effects of metoprolol and carvedilol on cause-specific mortality and morbidity in patients with chro nic heart failure – COMET // Am Heart J. – 2005. – Vol. 149 (2). – P. 370 - 6. DOI:10.1016/j. ahj. 2004.10.002. 30. van der Meer P., Gaggin H.K., Dec G.W. ACC/AHA Versus ESC Guidelines on Heart Failure: JACC Guideline Comparison // J Am Coll Cardiol. – 2019. – Vol. 73(21). – P. 2756 - 2768. doi: 10.1016/j.jacc.2019.03.478. 31. Yang Minwei., Chen Feng., Zhu Dingjun. et al. Analysis of the clinical efficacy of Liverin (oxymatrine) injection in the treatment of 40 cases of pneumonia caused by a new type of coronavirus // Journal Chinese Medicine. – 2020. - Vol. 45. 10. 32. Zhang Mingfa., Schen Yatsin. Study of the pharmacological effects of oxymatrine, a compound of the alcoloid type // Journal of Antimicrobial Pharmacology. - 2018. - Vol. 15 (2). - P. 369.

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