Očuvana kontraktilna rezerva leve komore podrazumeva sposobnost hipokinetičnih segmenata miokarda da pod dejstvom različitih inotropnih stimulusa poprave svoju kontraktilnost. Utvrditi razlike u kliničkim karakteristikama kod pacijenata sa dilatacionom kardiomiopatijom u zavisnosti od očuvane kontraktilne rezerve leve komore. U studiju je uključeno uzastopnih 55 bolesnika sa idiopatskom dilatativnom kardiomiopatijom. Svim bolesnicima uključenim u studiju urađen je stres ehokardiografski test fizičkim opterećenjem po standardnom protokolu. Postojanje očuvane kontraktilne rezerve je određivano uz pomoć promene ejekcione frakcije leve komore. Prosečna starost ispitivanih bolesnika je bila 54,98 ± 9,84 godina, 49 (89,1%) je bilo muškog pola. Na osnovu promene ejekcione frakcije leve komore kao kriterijuma kontraktilne rezerve leve komore, očuvanu kontraktilnu rezervu je imalo 25 bolesnika (45,5%). Bolesnici bez očuvane kontraktilne rezerve leve komore znatno češće u anamnezi imaju zastupljenu arterijsku hipertenziju (46,7 vs. 20,0%, p=0,038). Nema značajne razlike u zastupljenosti ostalih faktora rizika. Pacijenti sa očuvanom kontraktilnom rezervom leve komore imaju manju dimenziju leve komore na kraju sistole (49,64 ± 7,26 vs. 55,27 ± 8,36 mm, p=0.011), manji indeks volumena leve komore na kraju dijastole (77,35 ± 26,41 vs. 94,59 ± 34,97 ml/m2, p=0,005) i na kraju sistole (59,31 ± 26,05 vs. 78,62 ± 34,42 ml/m2, p=0,002), veću ejekcionu frakciju leve komore (25,48 ± 8,32 vs. 18,33 ± 6,49%, p=0,002) i niži indeks pokreta zidova leve komore (2,23 ± 0,27 vs. 2,48 ± 0,27, p=0,002). Kod bolesnika sa očuvanom kontraktilnom rezervom leve komore nalazimo manju zastupljenost arterijske hipertenzije i morfološki i funkcionalno manje oštećenu levu komoru.

Specific immunotherapy (SIT) has been used for almost a century but its form of administration is still a matter of
debate. At present curative SIThas only demonstrated its efficiancy, under the conditions that an appropriate allergen extract
is used, and patients are careffuly selected. However, many alergic patients likely to respond to immunotherapy are not
treated specificaly, due to the prevaling opinion that immunotherapy is ineffective, and has more uneffectable side effects
than drug treatment. Direct comparison of efficiancy between immunotherapy and drugs is problematic as this implies a
comparison between a treatment aiming at interfering with the pathophysiological mechanisms of the alergic inflammation
with potential for long term effect, or even cure (immunotherapy), and a treatment abolishing symptoms whi-le being
administered, but without long term preventive capacity (drugs). In most patients the situation is not an either but ra-ther
both and. The advantages of combinig immunotherapy and drugs are related to a higher likelihood of increasing effi-ciancy,
reducing side effects, and improving patient compliance by combining a treatment having an immediate effect with one
functioning more slowly