EFFECT OF L-ARGININE L-GLUTAMATE ON THE MORPHO-FUNCTIONAL STATE ON THE HEART AND LIVER IN PATIENTS WITH POSTINFARCTION CARDIOSCLEROSIS

Abstract

The liver and heart functional tests in patients with postinfarction cardiosclerosis were evaluated.

The aim of the study – to evaluate the effect of l-arginine l-glutamate on the morpho-functional state of the heart and liver in patients with postinfarction cardiosclerosis.

Materials and Methods. All patients were divided into 2 groups: group 2 (n = 49) – patients continued to make basic therapy of CHD, while patients of the group 1 (n = 50) received an additional drug – L-arginine L-glutamate (5 ml 40 % IV 7 days, then IV therapy changed to oral: 0.75g three times a day for 3 weeks. All patients underwent the following studies: a 24-hour holter monitoring, echocardiography, liver ultrasonography scanning and liver function tests (including alanine amino transferase (ALT ), aspartate amino transferase (AST ), alkaline phosphatase (ALP ), and bilirubin levels), lipid profiles (including total cholesterol, triglyceride (TG ), high density lipoprotein (HDL ) and low density lipoprotein levels (LDL )). All analyses were performed with the Statistical Package for “STAT IST ICA® for Windows 6.0” (StatSoft Inc.), Microsoft® Excel 2010 (Microsoft®).

Results and Discussion. L-arginine l-glutamine inclusion into the standard therapy of CHD demonstrated the reliable improvement of liver function: Level of total bilirubin was decreased by 26.3 %, ALT – by 48.5 %, and ALP – by 33 %. Level of total cholesterol was decreased by 16 %, LDL cholesterol – by 20.1 % and TG – by 24.4 %. Besides, level of HDL cholesterol was increased by 19.2 %. It was established, that on the background of L-arginine l-glutamine treatment took place statistically reliable improvement of the ultrasound liver parameters: liver size normalized in 35 % of patients, the structure of the capsular contour was restored – in 37 %. Normalized liver parenchymal echogenicity was noted in 29 % of patients and clear liver vascularity – in 41 %. LA size was decreased by 13.8 % , EDV by 12.5 %, ESV by 19.3 % and ejection fraction (EF) increased by 6.7 % in comparison with the initial data. The number of ischemic episodes per day decreased by 52.4 % in the group 1, the total duration of ischemic episodes per day decreased by 41 % in the group 1, the average duration of ischemic episodes decreased by 27.1 % in the group 1.

Conclusions. Inclusion into the standard therapy of CHD demonstrated the reliable improvement of liver function. A reliable lipidogram improvement was observed only in a group of patients who additionally took L-arginine L-glutamate. Anti-ischemic activity was higher in the group of patients with additional use of L-arginine L-glutamate. Thus, correction of the morphofunctional state on the heart and liver in patients with postinfarction cardiosclerosis by L-arginine L-glutamate is considered to be pathogenetically substantiated and clinically relevant.