Complex correction of metabolic changes and endothelial dysfunction in patients with ischemic heart disease and eff ort angina of functional class II

Objective: to study the role of free radical processes, disturbances in nitric oxide homeostasis and cholesterol metabolism in the formation of endothelial disorders in patients with chronic heart disease (CHD) with eff ort angina pectoris functional class II (FC); to substantiate the complex correction of disorders.  Material and methods. The study included 75 patients with coronary artery disease and eff ort angina FC II at the age of 50.1 ± 10 years old in the course of a year. The patients were divided into 4 groups: 1st group — control, 2nd group — data obtained on the background of basic therapy; 3rd group — basic therapy + atorvastatin; 4th group — a combination of basic therapy with atorvastatin and coenzyme Q 10 . In all patients, the intensity of lipid peroxidation, the activity of the antioxidant system, the content of NO metabolites and cholesterol metabolism were determined. To assess the functional state of the heart, an ECG study, daily ECG monitoring with the use of the Microvit MT-101 Holter system and blood pressure were performed.  Results. The data showed the development of oxidative stress, inhibition of AOD cells and a decrease in the NO metabolites content and impairment of its bioavailability due to atherogenic changes in the vascular wall. Metabolic changes were accompanied by hypertension, ECG changes and anginal attacks. Combined therapy with atorvastatin and coenzyme Q 10 against the background of basic therapy caused a positive dynamics of metabolic and functional disorders.  Conclusion. The results of complex therapy with an inhibitor of HMG-CoA reductase and coenzyme Q 10 proved the effi cacy of the infl uence on oxidation-reduction reactions, endothelial function, total cholesterol, LDL cholesterol, HDL cholesterol and functional parameters of the heart.