EFFECT OF METABOLIC THERAPY ON CORONARY CIRCULATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Keywords:
acute myocardial infarction, thrombolysis, coronary artery, occlusionAbstract
According to the World Health Organization, in 2020 coronary heart disease (CHD) will be one of the leading causes of disability and mortality in the population of developed countries. One of the most severe manifestations of IHD is acute myocardial infarction (MI).
In the pathogenesis of MI, that is, in the development of ischemic necrosis of the heart muscle, an important role is played by the complete cessation of blood supply to a certain area of the heart muscle as a result of acute occlusion of the coronary artery. 20-40 minutes after the cessation of blood flow in the coronary artery, the first degradation changes appear in cardiomyocytes. In the first hours after the cessation of blood flow through the coronary artery, 10-12 hours after microscopic necrotic changes in the myocardium, macroscopic foci of myocardial necrosis appear, indicating the expansion and deepening of the necrotic process. This determines the need to find ways to quickly and effectively restore blood flow in the coronary artery to stop the coagulation-necrotic process and myocytolysis in the heart muscle. Today, the most interesting group of drugs aimed at increasing the efficiency of myocardial oxygen use in ischemia is metabolic therapy. Changes in myocardial metabolism during ischemia and reperfusion open up a wide spectrum of drug action. We were faced with the task of choosing the optimal drug that meets the following requirements: the drug has a high bioavailability according to the mechanism of action, an energy substrate that easily and easily penetrates into the cardiomyocyte.
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