{"id":12101,"date":"2009-08-26T18:00:00","date_gmt":"2009-08-26T18:00:00","guid":{"rendered":""},"modified":"2009-08-26T18:00:00","modified_gmt":"2009-08-26T18:00:00","slug":"kardioprotekcija-zofenopriliu-gydant-miokardo-infarkta","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/kardioprotekcija-zofenopriliu-gydant-miokardo-infarkta\/12101\/","title":{"rendered":"Kardioprotekcija zofenopriliu gydant miokardo infarkt\u0105"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">Kardioprotekcija apima \u012fvairias gydymo priemones, kuriomis siekiama suma\u017einti \u016bminio miokardo infarkto pasekmes: mir\u0161tamum\u0105, \u0161irdies nepakankamumo ir skilvelini\u0173 \u0161irdies ritmo sutrikim\u0173 da\u017en\u012f. \u016aminio <a href=\"https:\/\/pasveik.lt\/ligos\/miokardo-infarktas\/4345\">miokardo infarkto <\/a>metu taikoma keletas kardioprotekcijos strategij\u0173. Vis\u0173 pirma tai kraujotakos vainikin\u0117je arterijoje atk\u016brimas (taikant tromboliz\u0119 ar angioplastik\u0105 naudojant ar nenaudojant stento t) ir antiagregant\u0173 (aspirino ar glikoproteino IIb-IIIa receptori\u0173 blokatori\u0173) ir\/ar antikoaguliant\u0173 (ma\u017eos molekulin\u0117s mas\u0117s heparin\u0173) skyrimas siekiant i\u0161saugoti kraujagysli\u0173 praeinamum\u0105. Antras etapas yra miokardo apsauga gydant \u03b2 adrenoblokatoriais ir angiotenzin\u0105 konvertuojan\u010dio fermento (AKF) inhibitoriais, kuri\u0173 naudos \u012frodym\u0173 nuolatos daug\u0117ja.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><strong><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">AKF inhibitori\u0173 kardioprotekcinis veikimas<\/span><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Reik\u0161ming\u0105 kardioprotekcin\u012f AKF inhibitori\u0173 poveik\u012f pacientams, sergantiems koronarine \u0161irdies liga, u\u017etikrina keletas mechanizm\u0173:<\/p>\n<p><\/span><\/p>\n<ul style=\"margin-top: 0cm\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Kraujo spaudimo suma\u017e\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Apsauga nuo kairiojo skilvelio (KS) remodeliavimosi\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">KS prie\u0161kr\u016bvio ir pokr\u016bvio suma\u017e\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Diastolin\u0117s funkcijos pager\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Simpatin\u0117s stimuliacijos suma\u017e\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Pusiausvyros tarp deguonies tiekimo ir suvartojimo miokarde pusiausvyros atk\u016brimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Endogenin\u0117s fibrinoliz\u0117s pager\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Nuo endotelio priklausomos vazodilatacijos pager\u0117jimas\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Antioksidacinis poveikis\n<\/p>\n<p><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Antii\u0161eminis poveikis\n<\/p>\n<p><\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Kuo grei\u010diau yra pradedama gydyti AKF inhibitoriais, tuo daugiau suma\u017e\u0117ja pacient\u0173, sergan\u010di\u0173 \u016bminiu miokardo infarktu (\u016aMI), mir\u0161tamumas. Ankstyvo gydymo AKF inhibitoriais svarba \u012frodyta trimis didel\u0117s apimties klinikiniais tyrimais \u2013 ISIS-4 (kaptoprilio), GISSI-3 (lisinoprilio) ir SMILE (zofenoprilio). \u0160i\u0173 tyrim\u0173 metu pacient\u0173 mir\u0161tamumas smarkiai \u2013 net 30\u201350 proc. Suma\u017e\u0117jo per pirm\u0105sias 24 val. po AKF inhibitoriaus paskyrimo. Tai rodo, kad AKF inhibitori\u0173 naud\u0105 lemia ne tik ilgalaikis \u0161i\u0173 vaist\u0173 poveikis kairiojo skilvelio (KS) remodeliavimuisi, kuris, kaip manoma, yra svarbiausias \u0161ios vaist\u0173 klas\u0117s veikimo mechanizmas.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Ankstyvojo \u016aMI pacient\u0173 mir\u0161tamumo suma\u017e\u0117jimas yra tiesiogiai proporcingas \u0161irdies renino- angiotenzino sistemos slopinimui. Klinikini\u0173 tyrim\u0173 rezultatai rodo, kad zofenoprilis pasi\u017eymi stipriausiu poveikiu \u0161irdies angiotenzin\u0105 konvertuojan\u010diam fermentui (1 pav.). SMILE tyrimo rezultatai parod\u0117, kad gydymas zofenopriliu dar daugiau suma\u017eino nepageidaujam\u0173 \u012fvyki\u0173 skai\u010di\u0173 pacientams, kuriems pasirei\u0161k\u0117 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipercholesterolemija\/4319\">hipercholesterolemija<\/a>, palyginti su pacientais, kuri\u0173 cholesterolio koncentracija buvo normali. Taigi neigiamas hipercholesterolemijos poveikis \u016bminio miokardo infarkto metu gali b\u016bti suma\u017eintas skiriant AKF inhibitori\u0173. Gydymas zofenopriliu pagerina didel\u0117s rizikos pacient\u0173, sergan\u010di\u0173 cukriniu diabetu, metaboliniu sindromu ar <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipercholesterolemija\/4319\">hipercholesterolemija<\/a>, prognoz\u0119.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><img loading=\"lazy\" decoding=\"async\" height=\"377\" alt=\"Kardioprotekcija zofenopriliu gydant miokardo infarkt\u0105\" width=\"571\" src=\"\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">SMILE tyrimai<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Zofenoprilis buvo i\u0161samiai i\u0161tirtas SMILE (angl. <i>The Survival of Myocardial Infarction Long term Evaluation<\/i>) tyrimuose: bandomajame SMILE tyrime, SMILE, SMILE-2 ir SMILE-ISCHEMIA. Pirmieji \u012frodymai, kad zofenoprilis suma\u017eina miokardo i\u0161emij\u0105 sergantiesiems \u016aMI, gauti atlikus bandom\u0105j\u012f SMILE tyrim\u0105 su \u016aMI sergan\u010diais pacientais, kuriems buvo taikyta arba netaikyta tromboliz\u0117. Zofenoprilis \u0161iems pacientams reik\u0161mingai suma\u017einokr\u016btin\u0117s anginos da\u017en\u012f, palyginti su \u012fprastiniu gydymu.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">SMILE tyrime dalyvavo 1556 didel\u0117s rizikos grup\u0117s priekiniu \u016bminiu MI sergantys ligoniai, kuriems nebuvo skirta trombolizin\u0117s terapijos. Ligoniams papildomai prie standartinio gydymo dar buvo skiriama zofenoprilio, po 7,5 mg du kartus per par\u0105, arba placebo. Zofenoprilio doz\u0117 pama\u017eu buvo didinama iki 30 mg du kartus per par\u0105, kol sistolinis AKS buvo didesnis nei 100 mmHg.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Po \u0161e\u0161i\u0173 savai\u010di\u0173 gydymo mirties arba sunkaus \u0160N i\u0161sivystymo da\u017enis buvo 10,6 proc. placebo grup\u0117je ir 7,1 proc. zofenoprilio grup\u0117je (p=0,018), t.y. santykinis rizikos suma\u017e\u0117jimas zofenoprilio grup\u0117je buvo 34,0 proc. Didel\u0117s rizikos pogrupi\u0173 analiz\u0117 parod\u0117, kad zofenoprilis reik\u0161mingai suma\u017eino mirties ir sunkaus \u0161irdies nepakankamumo rizik\u0105 pacientams, anks\u010diau patyrusiems miokardo infarkt\u0105, sirgusiems diabetu, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/krutines-angina\/4430\">kr\u016btin\u0117s angina<\/a> ar hipertenzija. Neseniai atlikta papildoma SMILE duomen\u0173 analiz\u0117 parod\u0117, kad zofenoprilis pagerina baigt\u012f ir pacientams, sergantiems miokardo infarktu be ST pakilimo.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Gydymo zofenopriliu nauda visi\u0161kai nepriklauso nuo sistolinio ir diastolinio kraujo spaudimo dyd\u017eio, nuo pradin\u0117s kairiojo skilvelio funkcijos bei jos poky\u010di\u0173, taip pat nepriklauso ir nuo greta skiriamo kito medikamentinio gydymo, kadangi \u0161ie parametrai buvo vienodi abiejose SMILE tyrimo tiriamosiose grup\u0117se.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">SMILE tyrimai parod\u0117, kad zofenoprilis suma\u017eina ateroskleroz\u0117s progresavim\u0105 d\u0117l antii\u0161eminio poveikio. Zofenoprilis i\u0161emini\u0173 \u012fvyki\u0173 na\u0161t\u0105 suma\u017eino 15 proc., ir \u0161is poveikis buvo statisti\u0161kai reik\u0161mingas vertinant beveik visas svarbiausias tyrimo baigtis.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">Kardioprotekcinis zofenoprilio poveikis<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">Zofenoprilis pasi\u017eymi dideliu veiksmingumu, reik\u0161mingu audini\u0173 selektyvumu ir ilga veikimo trukme bei nepertraukiamu AKF slopinimu miokarde. Taip pat zofenopriliui yra b\u016bdingos kardioprotekcin\u0117s savyb\u0117s bei skilveli\u0173 remodeliavim\u0105si slopinantis poveikis. I\u0161 kit\u0173 AKFI zofenoprilis i\u0161siskiria <i>sulfhidriline <\/i>molekul\u0117s dalimi, lemian\u010dia zofenoprilio geb\u0117jim\u0105 prijungti laisvuosius deguonies radikalus. Yra \u012frodyta, kad zofenoprilis pasi\u017eymi antioksidacin\u0117mis savyb\u0117mis tiek \u0161irdyje, tiek kraujagysl\u0117se, o \u0161ios savyb\u0117s padeda u\u017ekirsti keli\u0105 endotelio disfunkcijai, lemia antii\u0161emin\u012f, u\u017edegim\u0105 slopinant\u012f ir antiaterogenin\u012f zofenoprilio veikim\u0105. Tyrimais nustatyta, kad zofenoprilis didina azoto oksido (NO) gamyb\u0105, ma\u017eina ma\u017eo tankio lipoprotein\u0173 oksidacij\u0105 bei l\u0117tina aterosklerozini\u0173 pa\u017eeidim\u0173 progresavim\u0105 kraujagysl\u0117se (2 pav.). Klinikiniais tyrimais nustatytas ma\u017eesnis kardiovaskulini\u0173 \u012fvyki\u0173 da\u017enis gydant zofenopriliu rodo, kad antii\u0161eminis zofenoprilio poveikis yra svarbus pagerinant klinikin\u0119 baigt\u012f.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><img loading=\"lazy\" decoding=\"async\" height=\"507\" alt=\"Kardioprotekcija zofenopriliu gydant miokardo infarkt\u0105\" width=\"571\" src=\"\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><b><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">Apibendrinimas<\/p>\n<p><\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">AKF inhibitori\u0173 kardioprotekcinis poveikis pasirei\u0161kia pager\u0117jusios kairiojo skilvelio funkcijos bei hemodinaminio profilio d\u0117ka. Gydymas AKF inhibitoriais taip pat gali tur\u0117ti ir papildom\u0105 kardioprotekcin\u012f poveik\u012f, b\u016bding\u0105 konkre\u010diam vaistui. SMILE tyrimai parod\u0117, kad AKF inhibitorius zofenoprilis reik\u0161mingai pagerina \u016bminiu miokardo infarktu sergan\u010di\u0173 pacient\u0173 prognoz\u0119, pasi\u017eymi greitu ir ilgalaikiu palankiu poveikiu hemodinamikai ir miokardui bei kitomis teigiamomis savyb\u0117mis. Gydant zofenopriliu, sunki\u0173 kardiovaskulini\u0173 komplikacij\u0173 da\u017enis suma\u017e\u0117jo 30 proc., ir tai yra puikus kardioprotekcijos pavyzdys.<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u00a0<\/p>\n<p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><strong><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\">\u017durnalas \u201cGydymo menas\u201d<\/span><\/strong><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT\"><\/p>\n<p><\/span><\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none\"><span lang=\"LT\" style=\"font-size: 10pt; font-family: Arial; mso-bidi-font-size: 12.0pt; mso-ansi-language: LT\">Kardioprotekcija apima \u012fvairias gydymo priemones, kuriomis siekiama suma\u017einti \u016bminio miokardo infarkto pasekmes: mir\u0161tamum\u0105, \u0161irdies nepakankamumo ir skilvelini\u0173 \u0161irdies ritmo sutrikim\u0173 da\u017en\u012f. \u016aminio <a href=\"https:\/\/pasveik.lt\/ligos\/miokardo-infarktas\/4345\">miokardo infarkto <\/a>metu taikoma keletas kardioprotekcijos strategij\u0173. Vis\u0173 pirma tai kraujotakos vainikin\u0117je arterijoje atk\u016brimas (taikant tromboliz\u0119 ar angioplastik\u0105 naudojant ar nenaudojant stento t) ir antiagregant\u0173 (aspirino ar glikoproteino IIb-IIIa receptori\u0173 blokatori\u0173) ir\/ar antikoaguliant\u0173 (ma\u017eos molekulin\u0117s mas\u0117s heparin\u0173) skyrimas siekiant i\u0161saugoti kraujagysli\u0173 praeinamum\u0105. Antras etapas yra miokardo apsauga gydant \u03b2 adrenoblokatoriais ir angiotenzin\u0105 konvertuojan\u010dio fermento (AKF) inhibitoriais, kuri\u0173 naudos \u012frodym\u0173 nuolatos daug\u0117ja.<o:p><\/o:p><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[751,813,1141,1140],"site":[],"post_item_type":[27345],"class_list":["post-12101","post","type-post","status-publish","format-standard","hentry","tag-placebo","tag-tyrimai-parode","tag-zofenoprilio-poveikis","tag-zofenoprilis"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/12101","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=12101"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/12101\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=12101"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=12101"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=12101"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=12101"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=12101"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}