Thirty-two patients with chronic obstructive bronchitis (COB) aged 38 to 52 years (mean 40.5 +/- 3.8 years) who had clinical and functional parameters of NYHA functional class (FC) IV (WHO, 1998) pulmonary hypertension (PH). Hemodynamic parameters were recorded by M- and B-mode and Doppler echocardiography. The gaseous composition of blood was studied by the Astrup micromethod; the rheological properties of venous blood were explored by an AKP-2 rotational viscometer. According to their therapy, the examinees were divided into 2 groups. Group 1 included 18 patients given prestarium (Servier, France) in a dose of 2-4 mg/day. Group 2 (a control group) comprised 14 patients receiving the basal therapy provided by the medical and economical standards of therapy for COB. The studies have indicated that the inclusion of prestarium into the combined treatment of COB patients with FC IV PH promotes a significant improvement of the clinical status of patients, causes a reduction in the size of the right atrium (by 16.2%; p < 0.05) and the right ventricle (by 12.4%; p < 0.001), a 12.0%-fold increase in left ventricular ejection fraction. The drug produced no negative effect on ERF and blood gaseous composition and rheological properties. Therefore, a course and long-term use of prestarium in the combined therapy of COB patients with FC IV PH leads to clinical improvement, to correction of basic cardiohemodynamic parameters, and exerts a remodeling effect on the right and left ventricles, and improves life quality in patients.

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