Background. Currently, about 40 million people in the world suffer from heart failure (HF). The development of severe HF is most often caused by dilated cardiomyopathy (DCM) that is a frequent indication for heart transplantation worldwide. Despite significant advances in the medical treatment of this pathology, the morbidity, hospitalization rates, and mortality are constantly increasing. This study aimed to evaluate the effectiveness of hemosorption in patients with severe HF on the background of DCM compared to surgical left ventricular remodeling. Materials and methods. The study is based on the results of a retrospective study that included 80 patients with severe HF on the background of DCM (NYHA III–IV). In group 1 (59 patients; left ventricular ejection fraction (LVEF) 21.10 ± 4.66 %), conservative medical therapy was supplemented with a course of 3 hemosorption procedures using granular deligandizing hemosorbent. In group 2 (21 patients; LVEF 22.40 ± 2.27 %), patients underwent surgical interventions in the form of LV remodeling. Results. There was a significant improvement in the clinical state and LV contractility in both groups. In group 1, LVEF increased by 12.90 ± 2.06 % (p < 0.01), in group 2 — by 13.25 ± 2.98 % (p < 0.05). Howe­ver, more complications, longer hospital stay, and higher morta­lity were associated with LV remodeling. Conclusions. The use of extracorporeal hemocorrection methods in the comprehensive treatment of patients with DCM can improve the clinical state of patients, treatment outcomes and avoid the risks associated with surgical interventions.

Background. Heart failure is the leading cause of death among all cardiovascular diseases. The five-year survival rate in such patients is 50%. In most cases, heart transplantation is the treatment of choice in these patients. However, its use is limited by severe and progressive donor organ deficiency. The aim. To study the effectiveness of immunosorbent-based hemosorption in comprehensive conservative treatment of patients with end-stage heart failure. Materials and methods. A retrospective analysis of the results of treatment in 59 patients 90% men, 10% women; mean age 41.3 ± 12.4 years; NYHA IIB-III, baseline left ventricular ejection fraction 21.1 ± 4.66%, left ventricular endsystolic volume 206.87 ± 84.1 ml, left ventricular end-diastolic volume 264.4 ± 86.02 ml) hospitalized for end-stage heart failure was performed. Conservative therapy was carried out following international guidelines and was supplemented by a course of 2-4 hemosorption procedures for which hemosorbent granulated deliganding was used. The Student’s t-test was used to analyze the data. Results. The clinical condition of all patients improved after the performed hemosorption procedures by at least one NYHA class. The brain natriuretic peptide level decreased from 1281.17±165.33 pg/ml to 859.48±113.38 pg/ml (p<0.05). Left ventricular ejection fraction increased by 10.77±4.3% (to 29.36 ± 6.27%) (p<0.01), and after 12 months it was 34 ± 2.59% (p<0.05). Left ventricular end-systolic volume decreased by 68.75±43.56 ml (to 137.77 ± 33.21 ml), left ventricular end-diastolic volume decreased by 41.38±31.48 ml (to 238.04 ± 82.1 ml) (p<0.05). Conclusions. The use of hemosorption with hemosorbent granulated deliganding, against the background of conservative treatment of end-stage heart failure, improves the contractile function of the heart and general clinical condition of patients.