[Evaluation of different methods of treatment of patients with stable stenocardia combined with arterial hypertension according to echocardiographic data].

The authors evaluated the influence of three alternative methods of treatment of coronary artery disease (CAD) and stable exertional stenocardia accompanied by arterial hypertension on systolic and diastolic left ventricular (LV) function. The three methods were: conventional therapy with monocinque, chronotherapy with monocinque, and therapy with a combination of monocinque and melatonin. All the 65 patients aged 44 to 69 years underwent echoCG with Vivid 7 ultrasound scanner (USA) before and after the treatment. The study showed that chronotherapy with monocinque had the most favorable effect on LV diastolic function, which manifested by an increase in peak E from 0.47 +/- 0.02 to 0.53 +/- 0.02 m/s (p = 0.006) and peak E/peak A ratio from 0.77 +/- -0.05 to 0.93 +/- 0.05 (P = 0.002), as well as a decrease in peak A from 0.65 +/- 0.03 to 0.56 +/- 0.03 m/s (p = 0.05). Complex treatment with monocinque and melatonin improved systolic and diastolic LV function better than did conventional therapy. The favorable influence on myocardial contractility manifested by a reduction in end systolic LV size from 3.66 +/- 0.04 to 3.42 +/- 0.02 cm (p < 0.001), end diastolic LV volume from 126.7 +/- 1.3 to 118.4 +/- 1.1 ml (p < 0.001), and end systolic LV volume from 55.1 +/- 1.0 to 47.0 +/- 0.8 ml (p < 0.001), as well as an increase in ejection fraction from 56.5 +/- 0.9 to 60.3 +/- 0.8% (p = 0.003) and shortening fraction from 27.9 +/- 1.3 to 33.0 +/- 0.4% (p = 0.001). The normalizing effect on LV diastolic function manifested by an increase in peak E from 0.46 +/- 0.02 to 0.54 +/- 0.02 m/sec (p = 0.009) and peak E/peak A ratio from 0.68 +/- 0.05 to 0.82 +/- 0.05 (p = 0.002).