Ɏ ɎȺ ȺɄ ɄɌ ɌɈ ɈɊ Ɋɕ ɕ Ɋ Ɋɂ ɂɋ ɋɄ ɄȺ Ⱥ ɋ ɋɈ Ɉɋ ɋɌ ɌɈ Ɉə əɇ ɇɂ ɂȿ ȿ Ʉ ɄȺ ȺɊ ɊȾ Ⱦɂ ɂɈ ɈȽ Ƚȿ ȿɆ ɆɈ ɈȾ Ⱦɂ ɂɇ ɇȺ ȺɆ Ɇɂ ɂɄ Ʉɂ ɂ ɂ ɂ Ɏ Ɏɍ ɍɇ ɇɄ Ʉɐ ɐɂ ɂɂ ɂ ɉ ɉɈ Ɉɑ ɑȿ ȿɄ Ʉ ɍ ɍ ɉ ɉȺ Ⱥɐ ɐɂ ɂȿ ȿɇ ɇɌ ɌɈ Ɉȼ ȼ ɋ ɋ ɏ ɏɊ ɊɈ Ɉɇ ɇɂ ɂɑ ɑȿ ȿɋ ɋɄ ɄɈ ɈɃ Ƀ ɋ ɋȿ ȿɊ ɊȾ Ⱦȿ ȿɑ ɑɇ ɇɈ ɈɃ Ƀ ɇ ɇȿ ȿȾ ȾɈ Ɉɋ ɋɌ ɌȺ ȺɌ ɌɈ Ɉɑ ɑɇ ɇɈ Ɉɋ ɋɌ Ɍɖ ɖɘ ɘ ɂ ɂ ɂ ɂɇ ɇɎ ɎȺ ȺɊ ɊɄ ɄɌ ɌɈ ɈɆ Ɇ Ɇ Ɇɂ ɂɈ ɈɄ ɄȺ ȺɊ ɊȾ ȾȺ Ⱥ ȼ ȼ Ⱥ Ⱥɇ ɇȺ ȺɆ Ɇɇ ɇȿ ȿɁ Ɂȿ ȿ Ƚɍ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɚɤɚɞɟɦɢɹ ɆɁ ɍɤɪɚɢɧɵ» ɤɚɮɟɞɪɚ ɜɧɭɬɪɟɧɧɟɣ ɦɟɞɢɰɢɧɵ 2 (ɡɚɜ. -ɞ. ɦɟɞ. ɧ.,

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... ɪɨɮ. Ⱥ.ȼ. Ʉɭɪɹɬɚ) ɭɥ. ȼ. ȼɟɪɧɚɞɫɤɨɝɨ, , Ⱦɧɟɩɪ, 49044, ɍɤɪɚɢɧɚ SE «Dnipropetrovsk medical academy Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ ɯɪɨɧɢɱɟɫɤɚɹ ɫɟɪɞɟɱɧɚɹ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ, ɢɧɮɚɪɤɬ ɦɢɨɤɚɪɞɚ, ɤɚɪɞɢɨɝɟɦɨɞɢɧɚɦɢɤɚ, ɞɢɫɥɢɩɢɞɟɦɢɹ, ɤɚɪɞɢɨɪɟɧɚɥɶɧɢɣ ɫɢɧɞɪɨɦ .H\ ZRUGV chronic heart failure, myocardial infarction, cardiohemodynamics, dyslipidemia, cardiorenal syndrome Ɋɟɮɟɪɚɬ Ɏɚɤɬɨɪɢ ɪɢɡɢɤɭ ɫɬɚɧ ɤɚɪɞɿɨɝɟɦɨɞɢɧɚɦɿɤɢ ɿ ɮɭɧɤɰɿʀ ɧɢɪɨɤ ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɯɪɨɧɿɱɧɨɸ ɫɟɪɰɟɜɨɸ ɧɟɞɨɫɬɚɬɧɿɫɬɸ ɬɚ ɿɧɮɚɪɤɬɨɦ ɦɿɨɤɚɪɞɚ ɜ ɚɧɚɦɧɟɡɿ Ʉɭɪɹɬɚ 2ȼ Ɂɚɛɿɞɚ $$ ɑɜɨɪɚ ȾɅ Ⱥɤɬɭɚɥɶɧɿɫɬɶ ɩɪɨɛɥɟɦɢ ɫɟɪɰɟɜɨʀ ɧɟɞɨɫɬɚɬɧɨɫɬɿ ɞɥɹ ɫɭɱɚɫɧɨʀ ɦɟɞɢɰɢɧɢ ɡɭɦɨɜɥɟɧɚ ʀʀ ɡɪɨɫɬɚɸɱɨɸ ɩɨɲɢɪɟɧɿɫɬɸ ɿ ɧɟɫɩɪɢɹɬɥɢɜɢɦ ɩɪɨɝɧɨɡɨɦ, ɧɟɡɜɚɠɚɸɱɢ ɧɚ ɬɟɧɞɟɧɰɿɸ ɞɨ ɡɧɢɠɟɧɧɹ ɫɦɟɪɬɧɨɫɬɿ ɜɿɞ ɨɫɧɨɜɧɢɯ ɫɟɪɰɟɜɨ-ɫɭɞɢɧɧɢɯ ɡɚɯɜɨɪɸɜɚɧɶ: ɿɲɟɦɿɱɧɨʀ ɯɜɨɪɨɛɢ ɫɟɪɰɹ (ȱɏɋ) ɬɚ ɚɪɬɟɪɿɚɥɶɧɨʀ ɝɿɩɟɪɬɟɧɡɿʀ (ȺȽ). Ɇɟɬɚ ɪɨɛɨɬɢ: ɨɰɿɧɢɬɢ ɮɚɤɬɨɪɢ ɪɢɡɢɤɭ, ɫɬɚɧ ɤɚɪɞɿɨɝɟɦɨɞɢɧɚɦɿɤɢ ɬɚ ɮɭɧɤɰɿʀ ɧɢɪɨɤ ɭ ɩɚɰɿɽɧɬɿɜ ɡ ɯɪɨɧɿɱɧɨɸ ɫɟɪɰɟɜɨɸ ɧɟɞɨɫɬɚɬɧɿɫɬɸ (ɏɋɇ) ɿ ɝɨɫɬɪɢɦ ɿɧɮɚɪɤɬɨɦ ɦɿɨɤɚɪɞɚ (ȽȱɆ) ɜ ɚɧɚɦɧɟɡɿ. ɉɪɨɜɟɞɟɧɨ ɪɟɬɪɨɫɩɟɤɬɢɜɧɢɣ ɚɧɚɥɿɡ 144 ɿɫɬɨɪɿɣ ɯɜɨɪɨɛɢ ɩɚɰɿɽɧɬɿɜ ɡ ɏɋɇ ɡɿ ɡɛɟɪɟɠɟɧɨɸ ɫɢɫɬɨɥɿɱɧɨɸ ɮɭɧɤɰɿɽɸ ɭ ɜɿɰɿ 40-80 ɪɨɤɿɜ ɿ ɬɪɢɜɚɥɿɫɬɸ ɡɚɯɜɨɪɸɜɚɧɧɹ ɜɿɞ 1 ɪɨɤɭ ɞɨ 10 ɪɨɤɿɜ. ɉɚɰɿɽɧɬɢ ɛɭɥɢ ɪɨɡɩɨɞɿɥɟɧɿ ɧɚ 2 ɝɪɭɩɢ ɡɚɥɟɠɧɨ ɜɿɞ ɧɚɹɜɧɨɫɬɿ ɚɧɚɦɧɟɫɬɢɱɧɢɯ ɞɚɧɢɯ ɧɚ ɤɨɪɢɫɬɶ ɩɟɪɟɧɟɫɟɧɨɝɨ ȽȱɆ: 1 ɝɪɭɩɚ -35 ɩɚɰɿɽɧɬɿɜ (24 %) ɡ ɏɋɇ ɿ ȽȱɆ ɜ ɚɧɚɦɧɟɡɿ, 2 ɝɪɭɩɚ -109 ɩɚɰɿɽɧɬɿɜ (7,7%) ɡ ɏɋɇ ɛɟɡ ȽȱɆ ɜ ɚɧɚɦɧɟɡɿ. ȼɦɿɫɬ ɝɥɸɤɨɡɢ ɜ ɤɚɩɿɥɹɪɧɿɣ ɤɪɨɜɿ ɜɢɡɧɚɱɚɥɢ ɝɥɸɤɨɡɨɨɤɫɢɞɨɡɧɢɦ ɦɟɬɨɞɨɦ, ɡɚɝɚɥɶɧɨɝɨ ɯɨɥɟɫɬɟɪɢɧɭ ɬɚ ɬɪɢɝɥɿɰɟɪɢɞɿɜ ɭ ɫɢɪɨɜɚɬɰɿ ɤɪɨɜɿ -ɿɦɭɧɨɮɟɪɦɟɧɬɧɢɦɢ ɦɟɬɨɞɚɦɢ. Ⱦɥɹ ɤɥɿɧɿɱɧɨʀ ɨɰɿɧɤɢ ɮɭɧɤɰɿʀ ɧɢɪɨɤ ɜɢɡɧɚɱɚɥɢ ɪɿɜɟɧɶ ɤɪɟɚɬɢɧɿɧɭ ɜ ɫɢɪɨɜɚɬɰɿ ɤɪɨɜɿ ɡɚ ɞɨɩɨɦɨɝɨɸ ɤɨɥɨɪɢɦɟɬɪɢɱɧɢɯ ɦɟɬɨɞɿɜ ɿ ɨɛɱɢɫɥɸɜɚɥɢ ɲɜɢɞɤɿɫɬɶ ɤɥɭɛɨɱɤɨɜɨʀ ɮɿɥɶɬɪɚɰɿʀ ɡɚ ɮɨɪɦɭɥɨɸ CKD-EPI. Ȼɭɥɨ ɜɢɹɜɥɟɧɨ, ɳɨ ɩɨɲɢɪɟɧɿɫɬɶ ɿ ɬɹɠɤɿɫɬɶ ȺȽ, ɚ ɬɚɤɨɠ ɱɚɫɬɨɬɚ ɫɟɪɰɟɜɢɯ ɫɤɨɪɨɱɟɧɶ ɧɟ ɦɚɥɢ ɞɨɫɬɨɜɿɪɧɢɯ ɜɿɤɨɜɢɯ ɜɿɞɦɿɧɧɨɫɬɟɣ ɫɟɪɟɞ ɩɚɰɿɽɧɬɿɜ ɨɛɨɯ ɝɪɭɩ ɩɨɪɿɜɧɹɧɧɹ. ɋɟɪɟɞ ɩɚɰɿɽɧɬɿɜ ɡɿ ɫɬɚɛɿɥɶɧɢɦɢ ɮɨɪɦɚɦɢ ȱɏɋ ɬɚ ɏɋɇ ɡɿ ɡɛɟɪɟɠɟɧɨɸ ɮɪɚɤɰɿɽɸ ɜɢɤɢɞɭ ɛɭɥɚ ɜɫɬɚɧɨɜɥɟɧɚ ɞɨɫɬɨɜɿɪɧɨ ɛɿɥɶɲ ɜɢɫɨɤɚ ɩɨɲɢɪɟɧɿɫɬɶ ȺȽ, ɰɭɤɪɨɜɨɝɨ ɞɿɚɛɟɬɭ ɬɚ ɨɠɢɪɿɧɧɹ. ɇɚɹɜɧɿɫɬɶ ȽȱɆ ɜ ɚɧɚɦɧɟɡɿ ɚɫɨɰɿɸɜɚɥɨɫɶ ɡ ɩɨɝɿɪɲɟɧɧɹɦ ɤɨɧɬɪɨɥɸ ȺȽ ɧɚ ɬɥɿ ɧɨɪɦɚɥɶɧɢɯ ɩɨɤɚɡɧɢɤɿɜ ɥɿɩɿɞɨɝɪɚɦɢ ɩɨɪɿɜɧɹɧɨ ɡ ɩɚɰɿɽɧɬɚɦɢ ɡ ɏɋɇ ɛɟɡ ȽȱɆ ɜ ɚɧɚɦɧɟɡɿ. ȼɫɬɚɧɨɜɥɟɧɚ ɞɨɫɬɨɜɿɪɧɨ ɛɿɥɶɲ ɜɢɫɨɤɚ ɱɚɫɬɨɬɚ ɜɢɹɜɥɟɧɧɹ ɩɨɪɭɲɟɧɧɹ ɮɭɧɤɰɿʀ ɧɢɪɨɤ ɫɟɪɟɞ ɯɜɨɪɢɯ ɡ ɏɋɇ ɜɿɞɧɨɫɧɨ ɤɨɧɬɪɨɥɶɧɨʀ ɝɪɭɩɢ, ɩɪɢ ɧɚɹɜɧɨɫɬɿ ɬɟɧɞɟɧɰɿʀ ɞɨ ɡɪɨɫɬɚɧɧɹ ɩɪɨɹɜɿɜ ɯɪɨɧɿɱɧɨʀ ɧɢɪɤɨɜɨʀ ɧɟɞɨɫɬɚɬɧɨɫɬɿ ɿ ɝɿɩɟɪɭɪɢɤɟɦɿʀ ɫɟɪɟɞ ɩɚɰɿɽɧɬɿɜ ɡ ɩɿɫɥɹɿɧɮɚɪɤɬɧɢɦ ɤɚɪɞɿɨɫɤɥɟɪɨɡɨɦ, ɳɨ ɛɭɥɨ ɜɫɬɚɧɨɜɥɟɧɨ ɧɟɡɚɥɟɠɧɨ ɜɿɞ ɜɿɤɭ ɯɜɨɪɢɯ. $EVWUDFW 5LVN IDFWRUV FDUGLRKHPRG\QDPLFV DQG UHQDO IXQFWLRQ VWDWH LQ SDWLHQWV ZLWK FKURQLF KHDUW IDLOXUH DQG P\RFDUGLDO LQIDUFWLRQ LQ DQDPQHVLV .XU\DWD 29 =DELGD $$ &KYRUD '/ The importance of the problem of heart failure for modern medicine is due to its growing prevalence and poor prognosis, despite a tendency to decrease of deaths from major cardiovascular diseases: coronary heart disease (CHD) and arterial hypertension (AH). Objective: to evaluate the risk factors, the state of cardiac hemodynamics and kidney function in patients with chronic heart failure (CHF) and acute myocardial infarction (AMI) in history. A retrospective analysis of 144 case histories of patients with CHF with preserved systolic function, aged 40 to 80 years and with disease duration from 1 year to 10 years was made. The patients were divided into 2 groups depending on the presence of anamnestic data in favor of past AMI: group 1 -35 patients (24%) with CHF and AMI in anamnesis, 2 group, 109 patients (75,7%) with CHF without AMI in anamnesis. It was found that prevalence and severity of hypertension as well as arrhythmia were not significantly different in patients of both age groups. Among patients with stable angina and CHF with preserved ejection fraction there was established a high prevalence of hypertension, diabetes and obesity. The presence of AMI in anamnesis was associated with worse control of hypertension on the background of normal indicators of lipidogram, compared to patients with CHF without AMI in anamnesis. There was established a higher incidence of revealing patients with impaired renal function among patients with CHF with a trend to increase of manifestations of chronic renal failure and hyperuricemia among patients with postinfarction cardiosclerosis, regardless of patients' age. Ʉɥɸɱɨɜɿ ɫɥɨɜɚ ɤɨɦɩɥɟɤɫ ɿɧɬɢɦɚ-ɦɟɞɿɚ ɫɨɧɧɢɯ ɚɪɬɟɪɿɣ, ɚɬɟɪɨɫɤɥɟɪɨɡ, ɚɪɬɟɪɿɚɥɶɧɚ ɝɿɩɟɪɬɟɧɡɿɹ, ɰɢɪɤɚɞɧɢɣ ɪɢɬɦ ɚɪɬɟɪɿɚɥɶɧɨɝɨ ɬɢɫɤɭ, ɩɨɯɢɥɢɣ ɜɿɤ .H\ ZRUGV carotid intima media thickness, atherosclerosis, arterial hypertension, circadian rhythm of blood pressure, elderly age