Aim. Еvaluate the influence of combination therapy with fosinopril or zofenopril on the regulatory-adaptive status (RAS) of patients with diastolic chronic heart failure (CHF). Material and methods. The study includes 80 patients with CHF I-II functional class according to the classification of the New York heart Association with left ventricle ejection fraction ≥50% because of hypertensive disease (HD) of III stage, who were randomized into two groups for treatment with fosinopril (14.7±4.2 mg/day, n=40) or zofenopril (22.5±7.5 mg/day, n=40). As part of combination pharmacotherapy, patients were included nebivolol (7.1±2.0 mg/day and 6.8±1.9 mg/day), in the presence of indications, atorvastatin and acetylsalicylic acid in the intestinal shell were prescribed. Initially and after six months, the following was done: a quantitative evaluation of the RAS (by cardio-respiratory synchronism test), echocardiography, tredmil-test, six-minute walking test, determination of the N-terminal precursor of the natriuretic brain peptide level in blood plasma and subjective evaluation of quality of life. Results. Therapy, using fosinopril, in comparison with zofenopril, more improved RAS (by 66.5%, p

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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Aim. To determine effectiveness of combination therapy with lisinopril and fosinopril in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction (LV EF), considering its impact on the regulatory and adaptive capabilities organism. Materials and methods. 80 patients were examined with CHF II functional class with preserved systolic function of the left ventricle (left ventricular ejection fraction ≥50%) (classification of the New York Heart Association) in the presence of hypertension disease (HD) III stage and/or ischemic heart disease (IHD). Randomly divided into two equal groups. In the first group was appointed for treatment with lisinopril (the average dose was 14.0±3.8 mg/day), in the second group - fosinopril (the average dose - 14.7±4.2 mg/day). All patients were prescribed nebivolol (7.1±2.2 mg/day and 6.8±2.1 mg/day). Depending on the concomitant pathology were appointed acetylsalicylic acid in the intestinal shell (100 mg/day, n=9 and 100 mg/day, n=10) and atorvastatin (15.3±4.9 mg/day, n=15 and 16.5±4.8 mg/day, n=17). Initially and after six months later of combined pharmacotherapy studied: a quantitative assessment of regulatory and adaptive capabilities of the organism, echocardiography, treadmill test, six-minute walk test, determination in blood plasma of the N-terminal precursor of the natriuretic brain peptide level, all-day monitoring of blood electrocardiograms and pressure. The quality of life was also assessed using a questionnaire. Results. Both treatment regimens of patients equally improved the structural and functional parameters of the heart, reduced neurohumoral activity, optimized heart rate and pulse. In this case, treatment with fosinopril is more pronounced positively regulatory-adaptive capacity and tolerance to physical load, and also there was an improvement in the quality of life. Conclusion. In patients with CHF with preserved LV EF, in the presence of HD and/or IHD combined pharmacotherapy with fosinopril in comparison with lisinopril probably is preferable due to the more pronounced increase in regulatory and adaptive capabilities.