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Optimization of pharmacotherapy of chronic heart failure by using losartan, lisinopril and their association


Author: Tofan Elena
Degree:doctor of medicine
Speciality: 14.00.25 - Pharmacology, Clinical Pharmacology
Year:2015
Scientific adviser: Veaceslav Gonciar
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Ion Butorov
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 3 June, 2015 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.15 Mb / in romanian

Thesis

CZU 615.22:616.12-008.46

Adobe PDF document 7.41 Mb / in romanian
148 pages


Keywords

chronic heart failure, ischemic heart disease, losartan, lisinopril, combined therapy

Summary

The thesis structure: 148 pages of computer-writing which include: introduction, literature review, materials and methods, 2 chapters with the results of own researches, general conclusions, practical recommendations, bibliography which includes 163 sources, annexes, 33 tables and 42 figures. 12 scientific articles on the basis of the work are published.

Domain of application: pharmacology, clinical pharmacology.

Aim and objectives: to study the clinical and pharmacological aspects of angiotensin converting enzyme inhibitor lisinopril, angiotensin II receptor antagonist losartan and their combination in the treatment of chronic heart failure of II-IV functional classes.

Objectives. determine the evolution of clinical, hemodynamic and morpho-functional parameters of the heart of patients with ischemic CHF during complex treatment with losartan; to assess the efficacy of treatment with lisinopril complex of patients with ischemic CHF after development of clinical symptoms and morpho-functional hemodynamic parameters of heart; to assess effectiveness of treatment with losartan and lisinopril during complex pharmacotherapy of patients with CHF of ischemic origin; to study the influence of complex therapy with losartan and lisinopril and their tolerance during physical effort and quality of life of patients with CHF of ischemic origin; to develop individualized schemes of dosage and administration of lisinopril, losartan and their combination for the prolonged treatment of CHF of ischemic origin; monitoring the safety of complex therapy with losartan and lisinopril and their combination of patients with CHF of ischemic origin. Methodology of the scientific study. The study is clinical and analytical.

Novelty and originality of the work. For the first time were obtained new data on the correlation of efficacy and safety of combination therapy of angiotensin receptor antagonist and angiotensin converting enzyme inhibitor in complex treatment of CHF of ischemic origin. The results of the study have brought new visions on possibility and combined particularities of ACEI şi ARA in the treatment of CHF of ischemic origin, including the impact on quality of life and parameters reflecting the function of kidneys.

Scientific problemaddressed is to increase the effectiveness and safety of drug therapy in patients with CHF FC II-IV of ischemic origin using lisinopril, losartan or their association by optimization and individualization of regimens, rational use of preparations studied depending on their pharmacological properties and functional features of the patient.

Theoretical significance. The given research has allowed to obtain new data on the evolution of clinical picture, hemodynamic and morpho-functional parameters of the heart of patients with CHF FC II-IV of ischemic origin to treatment with losartan, lisinopril and their combination.

Applicative significance. Individualized pharmacological schemes of treatment of patients with CHF of ischemic origin with inclusion of lisinopril, losartan or their combination on basis of the complex study of the efficacy (clinical manifestations, morphofunctional and hemodynamic parameters of the heart, tolerance during pfysical efforts and quality of life) and safety of the treatment.

Implementing the results. The results of this study were implemented in medical practice at the Hospital of Ministry of Health of RM, at the University of Medicine and Pharmacy "Nicolae Testemitanu" - at the departments of Therapy, Pharmacology and Clinical Pharmacy, Pharmacology and Clinical Pharmacology.