International Medical Journal, Vol. 24., Iss. 3, 2018, P. 11−14.
THE INFLUENCE OF EPLERENONE THERAPY ON THE PROCESSES OF HEART REMODELING IN PATIENTS AFTER VALVE REPLACEMENT
Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
One of the important factors in heart failure pathogenesis is aldosterone, blood plasma concentration of which in such patients may exceed normal values by a factor of 20 due to an increase in its production and reduction of the clearance rate. Aldosterone acts as a water−salt metabolism regulator, contributing to retention of sodium and water, initiating the loss of potassium and magnesium ions and ultimately leading to hypervolemia and hemodynamic disorders. The presence of convincing evidence of the effectiveness of aldosterone antagonists in heart failure has been the basis for inclusion of this group of drugs in the recommendations on the management of patients with chronic heart failure. To study the efficacy of eplerenone a total of 15 patients with heart defects of various origin underwent dynamic observation within the period of 12 months after surgical treatment. The complex of diagnostic examination included physical examination, electrocardiography (ECG), echocardioscopy (ECHO) performed before surgical treatment, then at the stage of postoperative rehabilitation 1 month, 6 months and 12 months after the surgical treatment. The findings of the allowed the conclusion that eplerenone therapy leads to a more pronounced decrease in the size of the left ventricle in patients, who underwent valve replacement. Reduction of the size of the left atrium within 1 year after prosthetics occurs independently of therapy with drugs of the group of aldosterone receptors antagonists.
Key words: eplerenone, heart valve replacement, remodeling, heart failure.