At the same time there was no disputing the fact that the wait-and-see tactic in cases bessimptomnogo or malosimptomnogo currents SCOP possible only in the absence of a vnutrijeludockova obstruction obmorokov and serious violations of heart rhythm, which have been aggravated by heredity and the sudden deaths of close relatives. Variability forecast the need for a detailed risk stratification fatal complications of the disease, search available prognostic predictorov and criteria for evaluating the treatment. It should be recognized that the treatment SCOP, genetically based diseases usually raspoznavaemogo advanced as can be more symptomatic and palliative. However, the main purpose of treatment is not only the prevention and correction of the major clinical manifestations of the disease to the improvement in quality of life of patients, but also a positive impact on the forecast, for the prevention of sudden death and the progression of the disease. The pharmacological therapy SCOP drugs are the negative effects inotrope : β-adrenoblokatora blockers and calcium channel (verapamil). To treat very common to the disease of heart rhythm used дизопирамид and амиодарон. Β-adrenoblokatora was the first and remains to this day the most effective group of drugs used in treatment of SCOP. They have a good symptomatic effect on the main clinical manifestations : breathlessness and heart, controlling pain, including stenocardiu not less than half of patients SCOP because, basically, the ability of these drugs to reduce the need heart of oxygen. Thanks инотропному adverse effects and the reduction of activation симпатоадреналовой system in the physical and emotional stress of β-блокаторы prevent the emergence or strengthening внутрижелудочкового pressure gradient in patients with latent and лабильной obstruction, it is not affecting the value of the gradient at rest. I viewed the β-blokatorov improve functional status of patients with CAD and continuous use. While the drugs do not have direct influence on the relaxation diastolicescoe attack, they could improve LV filling indirectly, by reducing the heartbeat (HR) and the Cerebral heart muscle. The literature available evidence β-blokatorov ability to deter, and even lead to the opposite of thyroid diseases. Other authors stress that caused β-blokatorami symptomatic improvement is not accompanied by regression exaggerated LV and improved survival of patients. While the effect of these drugs on edema and prevent желудочковых and суправентрикулярных arrhythmias and sudden death has not been proved, several experts still believe that the appointment of preventive SCOP patients at high risk, including patients younger overburdened with cases of sudden death of a family history. Preference β-blokatoram no inner simpatomimeticescoy activity. The greatest experience Notes propranolola. His appoint, as of 20 mg 3-4 times a day with a gradual increase in dose control pulse, blood pressure (AD) to a maximum of portable, in most cases, 120 mg a day. Care must be taken to a possible higher doses of the drug as well as the lack of effective therapy β-блокаторами is probably due to insufficient dosage. Do not forget that the dosages significantly increases the risk of known side effects It is now widely considered the effective application of a new generation кардиоселективных β-блокаторов prolonged action, in particular атенолола, бисопролола etc. It is the view that cardioselektivee β-blokatora in patients SCOP have advantages over neselektivei because high doses, the use of which should be sought, selectivity almost lost.
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