Zusammenfassung

The pathogenesis of chronic heart failure (CHF) is a complex multifactorial process, which is a close combination of manifestations of the effects on the cardiovascular system of the etiological factor (s) and the mobilization of a whole complex of compensatory mechanisms [30]. According to the first conceptual models (cardiac (1950s) and cardiorenal (1960s)) pathogenesis, the main role in the formation of CHF belonged to a decrease in cardiac contractility (systolic dysfunction), as well as electrolyte retention and body water. [4, 14, 39]. The aim of the study was to study the role of the renin-angiotensin-aldosterone system and the natriuretic hormone in adaptive changes in water-salt homeostasis with an increase in venous blood return to the heart in healthy and in patients with stable ischemic heart disease with chronic heart failure stage I (stage I). The results of the study concluded: - in healthy individuals, an increase in venous return of blood to the heart (preload) in anti-orthostasis on the background of 0.5% water load is accompanied by adaptive changes in cardiohemodynamics, volemic homeostasis and neurohumoral regulation of water-salt metabolism, manifested by an increased influence of the parasympathetic department ANS, a decrease in heart rate, an increase in ASI while maintaining the IOC at the same level, an increase in diuresis, a decrease in the activity of the RAAS, an increase in the content of α-PNOG; - in patients with coronary artery disease with HNK I st. with an increase in preload at the 30th minute of anti-orthostasis, changes in cardio hemodynamics (decrease in IOC) and cardiac rhythmograms were revealed, indicating a depletion of myocardial reserve capacity and vegetative regulation of heart rhythm. The lack of heart rate dynamics and cardiac rhythmograms in anti-orthostasis reflects an increase in the activity of the sympathetic section of the autonomic nervous system in patients with coronary artery disease with the initial stage of HNK; - kidney reaction to anti-orthostasis ...