Ignatkina O.V. Autonomic regulation and efficiency of chronic heart failure therapy 
patients with enalapril and metoprolol in ambulatory practice. – Manuscript.

Dissertation for a Candidate’s of Medical Sciences degree by speciality 14.01.11 – 
Cardiology. – Dnepropetrovsk State Medical Academy and Gastroenterology  Institute, 
Dnepropetrovsk, 2005.

The aim of the study was to investigate the relation between  the efficiency of the 
chronic heart failure (CHF) patient’s  therapy  with  enalapril (EM) and metoprolol 
(MT) and initial state of autonomic heart regulation. The spectral analysis of heart
rate variability (HRV) was used like the investigation method for the assessment of
autonomic heart regulation. The changes  of  the state  of heart regulation, clinic  
and haemodiynamic parameters and quality of patient’s life were estimated.
Results of research have confirmed the fact of reduction of the total power (TP) of
HRV  at CHF patients. High clinical efficiency  of CHF  therapy with  Å̀ and ̀̉ was 
confirmed. Use of acute pharmacological tests (PT) with these drugs and the dynamic
control of HRV parameters for the increasing  of efficiency of the CHF therapy have 
been proved. The high initial ̉Đ and its  increase  at the PT or during CHF therapy 
are the higher survival predictors of patients within three years. 
The investigation confirms existence of individual sensitivity  of  autonomic heart 
regulation and proves HRV  method  can be used in  the clinical  man agement of the 
treatment of CHF patients in ambulatory practice.

Key words: chronic heart failure, heart rate variability, enalapril, metoprolol, 
therapy efficiency.