Aim. To determine the effect of combined therapy with nebivolol or carvedilol on the functional state of patients with diastolic chronic heart failure (CHF). Material and methods. The study involved 68 patients with CHF and preserved left ventricular ejection fraction, who were randomized into two groups for treatment with bisoprolol or carvedilol. As part of the combination therapy was prescribed quinapril, and if indicated atorvastatin, acetylsalicylic acid in the intestinal soluble shell. Initially and after 24 weeks of therapy were carried out: quantitative assessment of regulatory-adaptive status (RAS), echocardioscopy, treadmill test, six-minute walking test, subjective assessment of quality of life, determination of level of N-terminal fragment of the brain natriuretic peptide precursor in blood plasma. Results. Both schemes of combined therapy comparably improved the morpho-functional parameters of the heart and quality of life. In comparison with carvedilol, nebivolol more pronouncedly increased RAS and tolerance to physical activity. Conclusion. In patients with diastolic CHF in combination therapy, the use of nebivolol, in comparison with carvedilol, may be preferable due to the positive effect on the functional state.

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Objective. To determine the effect of bisoprolol or carvedilol therapy on the regulatory-adaptive status (RAS) of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV) the background of hypertensive disease (HD).Material and methods. The study involved 68 patients with CHF and pEF of the LV, who were randomized into two groups for treatment with bisoprolol (7,3±2,4 mg/day, n=34) and carvedilol (28,4±12,3 mg/day, n=34). As part of the combination therapy, quinapril was prescribed (13,5±2,5 mg/ day, n=34 and 12,6±2,9 mg/day, n=34), and if indicated – atorvastatin (16,3±5,0 mg/day, n=11 and 15,5±5,2 mg/day, n=11) and acetylsalicylic acid in the intestinal soluble shell (93,8±17,7 mg/day, n=8 and 94,4±15,8 mg/day, n=8), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of RAS (by means of a sample of cardiac-respiratory synchronism), treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal fragment of brain natriuretic peptide, echocardioscopy, daily monitoring of blood pressure.Results. Both regimens of combined drug therapy had comparable cardioprotective, hypotensive and neuromodulating effects, equally increased exercise tolerance. In comparison with bisoprolol, carvedilol differed positive impact on RAS, improved quality of life more.Conclusion. In patients with CHF and pEF LV in combination therapy, the use of carvedilol, in comparison with bisoprolol, may be preferable due to the positive effect on the RAS.

Background. Chronic heart failure (CHF) is the most common outcome of cardiovascular disease, of hypertension disease (HD). Beta-blockers contribute to the correction of hypertension, reduce heart remodeling, slow the progression of CHF. At the same time, bisoprolol and nebivolol differing pharmacochemical properties can have a multidirectional effect on the regulatory-adaptive status (RAS). Aim. To determine the effect of bisoprolol or nebivolol therapy on the RAS of patients with diastolic CHF on the background of HD III stage. Material and methods. The study involved 68 patients with diastolic CHF who were randomized into two groups for treatment with bisoprolol or nebivolol. As part of the combination therapy, patients were administered quinapril was prescribed (13.52.5 mg/day, n=34 and 12.82.8 mg/day, n=34), and if indicated, acetylsalicylic acid, atorvastatin. Initially and after 24 weeks of therapy were carried out: quantitative assessment of RAS, echocardiography, treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal propeptide of brain natriuretic hormone in blood plasma, daily monitoring of blood pressure. Results. Both schemes of combined therapy comparably improved the structural and functional state of the heart, controlled arterial hypertension. In comparison with bisoprolol, nebivolol differed positive impact on RAS, more increased tolerance to physical activity and improved quality of life. Conclusion. In patients with diastolic CHF and HD III stage, the use of nebivolol in combination therapy may be preferable due to the positive effect on RAS, in comparison with bisoprolol.

Objective. Compare the eff ect of combination therapy with nebivolol or carvedilol on the functional state of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV). Material and methods. The study involved 80 patients with diastolic CHF, who were randomized into two groups. In group I was appointed of nebivolol (7.7 ± 2.4 mg/day, n = 40), in group II — carvedilol (30.5 ± 8.7 mg/day, n = 40). As part of the combination therapy, quinapril was prescribed (13.7 ± 2.7 mg/day, n = 40 and 13.5 ± 2.6 mg/day, n = 40), and if indicated — atorvastatin (15.3 ± 4.6 mg/day, n = 17 and 16.2 ± 5.2 mg/day, n = 17) and acetylsalicylic acid in the intestinal soluble shell (96.4 ± 13.4 mg/day, n = 14 and 93.8 ± 13.3 mg/day, n = 13), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of regulatory-adaptive status (RAS) (by means of a sample of cardiac-respiratory synchronism), echocardioscopy, treadmill test, test with a six-minute walk, subjective assessment of quality of life, determination of the level of the N-terminal fragment of the brain natriuretic peptide in blood plasma, daily monitoring of blood pressure. Results. Both schemes of combined therapy comparably improved the structural and functional state of the heart, controlled arterial hypertension. In comparison with carvedilol, nebivolol diff ered positive eff ect on the RAS, more increased tolerance to physical activity and improved quality of life. Conclusion. In patients with CHF pEF LV in combination therapy, the use of nebivolol, in comparison with carvedilol, may be preferable due to the more pronounced positive eff ect on the functional state.