Complex approach to treatment of myocardial infarction combined with non-alcoholic fatty liver disease

Ye.I. Kinoshenko, V.V. Nikonov, I.Ye. Bila, V.I. Kolomyiets

Abstract


Background. In the complex treatment of myocardial infarction (MI), combined with non-alcoholic fatty liver disease (NAFLD) the application of drugs with protective properties is of current interest. The purpose of research is to study the effectiveness of Thiotriazoline and Enerliv in the complex treatment of patients with acute MI, combined with hepatic steatosis or non-alcoholic steatohepatitis. Materials and methods. The study involved 47 patients with acute MI with Q wave, combined with NAFLD. The study of electrical activity of the heart was performed on an improved polygraph with the regi­stration of electric and vectorcardiogram before and after the three-week therapy with basic drugs of 16 patients (13 men and 3 women, average age — 60,5 ± 3,74 years), with the addition of Thiotriazoline of 16 patients (8 men and 8 wo­men, average age — 62,94 ± 2,71 years), and with Thiotriazoline and essential phospholipids in combination with basic therapy of 15 patients (10 men and 5 women) aged 36 to 75 years (ave­rage age — 60,0 ± 3,36 years). Results. The treatment with basic drugs caused a further decrease in the electromotive force of the heart with the slowing of the pulse and the violation of the late repolarization process in the myocardium of the ventricles and atria with a decrease in the damage zone in the left ventricle and atrial overload. Simultaneous use of Thiotriazoline and basic drugs caused minimal positive changes in the electromotive force of the heart. In addition, the area of ischemia increased through reducing of myocardial damage zones, normalization of the left atrium became more marked, and repolarization in the atria stabilized. The use of a therapeutic complex that included basic drugs and Thiotriazoline and essential phospholi­pids contributed to a significant increase in bioelectric potentials of ventricular myocardium with the local improvement of speed parameters and a more marked recovery of cardiomyocytes in the periphery of the damaged area. The effect of the combination of drugs on the prameters of the atrial component of electrical activity of the heart shows the significant mediated hemodynamic atrial unloading, initially improved by contractile abi­lity of the left ventricle with further normalization of repolarization in atrial myocardium. Conclusions. The most effective complex for the treatment of acute MI with Q wave in patients with NAFLD is Thiotriazoline and essential phospholipids in combination with basic drugs. Their simultaneous use poten­tiates the positive properties of both drugs.


Keywords


acute phase of myocardial infarction; non-alcoholic fatty liver disease; vectorcardiogram; Thiotriazoline

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DOI: https://doi.org/10.22141/2224-0586.1.80.2017.94451

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