Complex approach to treatment of myocardial infarction combined with non-alcoholic fatty liver disease
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.
Full Text:PDF (Русский)
Handzyuk VA. Morbidity analysis of ischemic heart disease in Ukraine. Ukrainian Cardiology Journal. 2014;3:45-52. (In Ukrainian).
Vovk EI. Fatty liver disease is in therapeutic practice. Russian medical journal. 2009;2. http://www.rmj.ru/articles_6880.htm. (In Russian).
Sîrbu O, Floria M, Dăscălița P., Şorodoc V, Şorodoc L. Non-alcoholic fatty liver disease-From the cardiologist perspective. Anatol J Cardiol. 2016 Jul;16(7):534-41. doi: 10.14744.
Van Wagner LB, Wilcox JE, Colangelo LA et all. Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: A population-based study. Hepatology. 2015 Sep;62(3):773-83. doi: 10.1002/hep.27869.
Toporkov AS, Topchij NV. The possibilities of application the Thiotriazoline as metabolic therapy medicine. Russian medical journal 2015; 15. http:// www.rmj.ru/articles/kardiologiya/Vozmoghnosti_primeneniya_Tiotriazolina_v_kachestve_sredstva_metabolicheskoy_terapii/. (In Russian).
Savchenko MA, Yаrmolovich VV, Vlasenkova ES, Boris MA. Usage of thiotriazoline in outpatient practice: experience and prospects. Medicinskie novosti. 2013;9:69-73. (In Russian).
Golovanova EV, Kolechkina IA. Experience with thiotriazoline in the treatment of patients with alcoholic liver disease. Eksp Klin Gastroenterol. 2012,3:96-9.
Samogal`s`ka O Ye. Research of effectiveness of «thiotriazoline»’s different doses at chronic diffuse liver diseases. Suchasna gastroneterologiya 2006;28(2):34-9. (In Ukrainian).
Filonenko MV. The influence of metabolic therapy on the antioxidant system at patients with acute myocardial infarction combined with chronic hepatitis. Bukovy`ns`ky`j medy`chny`j visny`k. 2008;12(4):87-90. (In Ukrainian).
Kolesnikova EV. Modern phospholipid drugs in treatment of different etiology liver diseases. Suchasna gastroneterologiya. 2013;73(5):75-6. (In Russian).
Nichitaĭlo ME, Bulik LM. Application of essential phospholipids in the treatment and prophylaxis of postcholecystectomy syndrome. Klin Khir. 2012; Jul;7:42-4.
Prihod'ko V YU. Effectiveness of Enerliv in elderly patients with ischemic heart disease receiving hypolipidemic therapy by statins. Novosti mediciny i farmacii. 2010;321(8). http://www.mif-ua.com/archive/article/12392. (In Russian).
Van de Werf F, Bax J, Betriu A et al. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J. 2008;29(23):2909-45. doi: 10.1093.
Pathologic physiology. Pod red. AD Ado, VV Novickogo. Tomsk: Izd-vo Tom. un-ta; 1994. 468р. (In Russian).
Ataman AV. Pathologic physiology in questions and answers: teaching aid. Vinnica: Nova Kniga; 2008. 544р. (In Russian).
- There are currently no refbacks.
Copyright (c) 2017 EMERGENCY MEDICINE
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018