[Endothelial dysfunction in patients with chronic heart failure, and possibilities of its correction with isosorbide-5-mononitrates].

Vascular endothelial dysfunction has been proven to play an important role in the development and progression of chronic heart failure (CHF). The influence of isosorbide-5-mononitrate monocinque on endothelial function in patients with NYHA II class chronic heart failure complicating the course of coronary artery disease (CAD) with II--III class stable exertional stenocardia was studied. Disturbances in endothelium-dependent vasodilation in a form of a lowered endothelial response to an increase in shift tension during reactive hyperthermia test were noted in patients with CHF complicating CAD. After 12 weeks of treatment with monocinque endothelium-dependent vasodilation normalized, which manifested by an increase in the vasodilating response of the brachial artery to stimulation with an increased flow from 8.2 +/- 1.3 to 11.1 +/- 1.0%. Monocinque administered in a day dose of 40 mg possessed antianginal activity in 85.7% of patients: the frequency of anginal attacks lowered by 59.3%, morphofunctional heart parameters improved which manifested by a 8.7% increase in ejection fraction. Side effects of monocinque, typical of nitrates, were noted in 17.9% of patients and did not require discontinuation of the therapy.