Mildronate effectiveness in post-hospital rehabilitation of patients with myocardial infarction

Кардиоваскулярная терапия и профилактика

V. P. Mikhin¹  O. N. Koltsova¹ 

[1] Kursk State Medical University, Kursk;

关键词: cytoprotectors;    mildronate;    myocardial infarction;    exercise capacity;    left ventricular diastolic function;   

DOI  :  10.15829/1728-8800-2012-2-57-61

来源: DOAJ

【 摘 要 】

Aim. To study the effects of mildronate, as a component of complex therapy, on left ventricular (LV) systolic and diastolic function and exercise capacity (EC) in myocardial infarction (MI) patients undergoing post-hospital rehabilitation. Material and methods. This open, randomized study included 2 groups (50 men in each group; mean age 53,8±2,7 years): the control group (CG) and the main group (MG), which suffered MI in 4 weeks prior to the study inclusion (70% with Q-wave MI and 30% with transmural MI), and had stable post-infarction angina, Functional Class (FC) II, and ejection fraction (EF) >35%. In both groups, pharmaceutical therapy included metoprolol (75-150 mg/d), isosorbide mononitrate (40 mg/d), aspirin (100 mg/d), clopidogrel (75 mg/d), atorvastatin (20-40 mg/d), and enalapril (2,5-5 mg/d). The MG patients additionally received mildronate (1,5 g/d) for 3 months. The follow-up period was 1 year. EC was assessed using veloergometry (VEM) and 6-minute walk test (6MWT). LV systolic and diastolic function was assessed with the use of Doppler echocardiography. The following parameters were calculated: EF, DTE, LV isovolumetric relaxation time (IVRT), and enddiastolic pressure (EDP). Two types of diastolic dysfunction (DD) were defined: Type I (E/A <1; DTE >0,220 ms) and Type II (E/A >1,5; DTE <0,150 ms). Results. Mildronate therapy facilitated EC recovery, improved VEM threshold capacity, and increased 6MWT velocity and distance. In addition, mildronate improved LV systolic and diastolic function in both types of DD, by increasing EF and reducing EDP. In type I DD, E/A and IVRT increased, while DTE decreased. In Type II DD, the changes were also positive, but different: E/A decreased, while IVRT increased. Conclusion. Adding mildronate to the complex therapy of MI patients at the post-hospital rehabilitation stage facilitates EC improvement and benefits LV systolic and diastolic function.

【 授权许可】

Unknown