Evaluation of the diastolic properties of the left ventricular myocardium (LV) in patients with hypertensive heart is relevant due to the fact that they, forming against the background of an increase in LV myocardial mass, are able to progress, manifesting clinical syndrome of chronic heart failure mainly in old age. The aim is to determine the effectiveness of perindopril and ivabradine in correcting blood pressure and heart rate, as well as functional parameters of LV myocardium, vasoregulatory function of peripheral arterial endothelium in patients with hypertension. Object and methods. The study included 43 men aged 52 to 64 years with a diagnosis of hypertension without systematic use of antihypertensive drugs in the past, who did not have clinical signs of chronic heart failure, with a sinus rhythm at rest of more than 75 per minute. The control group consisted of 21 men, comparable in age, without abnormalities on electrocardiography and physical signs of heart disease. All patients included in the study underwent an echocardiographic examination, which determined the main parameters at rest. Pulse-wave Dopplerography of the LV inflow pathway was also used, and in the tissue dopplerography mode, the speed of movement of the lateral part of the mitral valve ring and the LV myocardial productivity index were evaluated. Load testing was carried out on a bicycle ergometer for 2 minutes with a power of 25, 50 and 75 watts. Endothelial function and stiffness systemic arteries were assessed by finger computed photoplethysmography. The study was divided into 3 visits: on the 1st, patients were prescribed perindopril at a dose of 10 mg / day; on the 2nd, ivabradine was added at a dose of 7.5 mg 2 times a day for a month; the 3rd visit was the final stage of the study. Results. According to blood pressure measurements at the last visit, the group of patients with hypertension did not differ from the control group in systolic and diastolic pressure while lying, sitting, and at a load of 25 watts. The addition of ivabradine to perindopril increased the bradycardic effect significantly equalized the group of patients with the control heart rate in the entire range of physiological conditions. The index of peripheral arterial endothelial function completely returned to normal during the follow-up. When studying the LV myocardial performance index, we have shown that performing physical activity and changing body position can significantly influence its increase in both healthy and hypertensive heart patients. Conclusion. A significant hypotensive effect of perindopril at rest, under dynamic load, and the effectiveness of ivabradine in normalizing heart rate have been demonstrated. The high sensitivity of the LV phase myocardial index as a marker of left ventricular dysfunction, dynamic changes in the index in response to normalization of blood pressure and pulse regardless of LV myocardial mass, as well as the possibility of normalization of the vasomotor function of the vascular endothelium of peripheral arteries, which creates the basis for improving the parameters of vascular rigidity in the future.

diastolic dysfunction, phase myocardial index, chronic heart failure, perindopril, ivabradine.

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