Metabolic therapy in chronic heart failure


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Abstract

The modern conceptions of the role of free fatty acids (FFA) and glycolysis in the energy metabolism of the myocardium are considered. Experimental models of myocardial ischemia have shown that some medicines are capable of altering the metabolism in cardiomyocytes, transferring it from FFA oxidation to more efficient process - the oxidation of glucose and lactate. In coronary artery disease, cardiomyocyte metabolism may vary depending on the stage of chronic heart failure (CHF). Some changes are compensatory in nature, thereby they partially improve the impaired metabolism, while others may further depress processes of energy formation in the myocardium. Drugs that have the ability to influence metabolic processes in myocardium include cytoprotectors, antioxidants and antihypoxants. Trimetazidine and ranolazine fall into the first group; ubiquinone refers to the second group. Cytochrome C deserves special attention among antihypoxants. Results of clinical studies carried out in the cardiological practice have shown that this drug has a good clinical effect in patients with cardiovascular diseases, including CHF, significantly improves myocardial function in hypoxic conditions and allows optimizing the treatment of patients. Given the «universality» of the action of Cytochrome C and its safety, this drug can be used also in other diseases accompanied by hypoxia (diabetes mellitus, compromised liver function and cerebral circulation disorders).

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About the authors

Viktor Vladimirovich Cheltsov

Medical Center of Affairs of the Moscow Mayor and Moscow Government

Email: vcheltsov@mail.ru
MD, professor

Anatoliy Ivanovich Martynov

A.I. Yevdokimov Moscow State Medical and Dental University

Email: mailbox@rnmot.ru
academician of Russian Academy of Sciences, MD, professor of Department of Hospital Therapy № 1, Medical Faculty

Yuliya Shamilevna Gushchina

Russian Peoples' Friendship University

Email: gushchina@mail.ru
PhD, Associate Professor, Department of General and Clinical Pharmacology, Medical Faculty

Tatiana Semenovna Illarionova

Russian Peoples' Friendship University

Email: illarionova@med.rudn.ru
PhD, Associate Professor, Department of General and Clinical Pharmacology, Medical Faculty

Elina Arkadevna Korovyakova

Russian Peoples' Friendship University

Email: elinakor@mail.ru
PhD, Associate Professor, Department of General and Clinical Pharmacology, Medical Faculty

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