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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">rpcardio</journal-id><journal-title-group><journal-title xml:lang="en">Rational Pharmacotherapy in Cardiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Рациональная Фармакотерапия в Кардиологии</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1819-6446</issn><issn pub-type="epub">2225-3653</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20996/1819-6446-2016-12-5-574-581</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-1339</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>INNOVATIVE CARDIOLOGY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИННОВАЦИОННАЯ КАРДИОЛОГИЯ</subject></subj-group></article-categories><title-group><article-title>Modulation of Cardiac Contractility – a New Method in the Treatment of Heart Failure</article-title><trans-title-group xml:lang="ru"><trans-title>Модуляция сердечной сократимости – новый метод в терапии сердечной недостаточности</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петрухина</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrukhina</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., н.с. отдела заболеваний миокарда и сердечной недостаточности, РКНПК</p></bio><bio xml:lang="en"><p>MD, PhD, Researcher of Department of Myocardial Diseases and Heart Failure, Russian Cardiology Research and Production Complex</p></bio><email xlink:type="simple">angelina-heart@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Терещенко</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Tereshchenko</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, руководитель отдела заболеваний миокарда и сердечной недостаточности, РКНПК</p></bio><bio xml:lang="en"><p>MD, PhD, Professor, Head of Department of Myocardial Diseases and Heart Failure, Russian Cardiology Research and Production Complex</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жиров</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhirov</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., в.н.с. отдела заболеваний миокарда и сердечной недостаточности, РКНПК</p></bio><bio xml:lang="en"><p>MD, PhD, Leading Researcher of Department of Myocardial Diseases and Heart Failure, Russian Cardiology Research and Production Complex</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский кардиологический научно-производственный комплекс Россия, 121552, Москва, ул. 3-я Черепковская, 15а</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Cardiology Research and Production Complex. Tretya Cherepkovskaya ul. 15a, Moscow, 121552 Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2016</year></pub-date><pub-date pub-type="epub"><day>06</day><month>11</month><year>2016</year></pub-date><volume>12</volume><issue>5</issue><fpage>574</fpage><lpage>581</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Petrukhina A.A., Tereshchenko S.N., Zhirov I.V., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Петрухина А.А., Терещенко С.Н., Жиров И.В.</copyright-holder><copyright-holder xml:lang="en">Petrukhina A.A., Tereshchenko S.N., Zhirov I.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpcardio.online/jour/article/view/1339">https://www.rpcardio.online/jour/article/view/1339</self-uri><abstract><p>The review analyzes new treatment for patients with chronic heart failure (CHF) with low ejection fraction – cardiac contractility modulation (CCM). CCM is carried out by supplying electric signals to an absolutely refractory ventricular myocardium, to elicit a positive inotropic effect without increasing myocardial oxygen consumption. These effects are independent on QRS duration; consequently, the therapy might be beneficial for patients who are not candidates for cardiac resynchronization therapy (CRT). It should be noted that the use of CCM treatment of CHF should begin only with maximum active therapy when its efficacy is not enough. It is not an alternative, but complement to the most active treatment of patients. Clinical studies primarily focused on patients with normal QRS duration because the CPT is optimal treatment of patients with prolonged QRS. The article focuses on the prerequisites for the development of the method and discusses the results obtained when evaluating the clinical efficacy and safety of treatment of patients with CHF in randomized clinical trials FIX-HF-3 (n=25), FIX-HF-4 (n=164), FIX-HF-5 (n=428). The total number of patients included into these studies was 617 people. Baseline patient characteristics were similar for all 3 studies. All participants received optimal medical therapy, had a normal QRS duration. All patients were II and III functional class (by NYHA). The studies analyzed the changes in NYHA class, ejection fraction, peak oxygen consumption (VO2), the precursor of brain natriuretic peptide (NT-proBNP) level. Quality of life was assessed by the Minnesota questionnaire; the mortality rate was compared with that predicted by MAGGIC scale. CCM therapy had beneficial effect on the survival and quality of life in patients with CHF. However, more data is needed to assess long-term effects of the CCM therapy.</p></abstract><trans-abstract xml:lang="ru"><p>Обзор анализирует новый метод лечения больных c хронической сердечной недостаточностью (ХСН) и низкой фракцией выброса – модуляцию сердечных сокращений (МСС). МСС осуществляется за счет подачи электрических импульсов в абсолютно рефрактерный миокард желудочков, что приводит к положительному инотропному эффекту без увеличения потребности миокарда кислородом. Использование метода не зависит от длительности комплекса QRS, следовательно, может быть показана пациентам, не подходящим для проведения сердечной ресинхронизирующей терапии (СРТ). Следует отметить, что применение МСС для лечения ХСН должно начинаться только на фоне максимально активной терапии при ее недостаточной эффективности. Это не альтернатива, а дополнение к максимально активной терапии больных. Клинические исследования в первую очередь нацелены на пациентов с нормальной длительностью QRS ввиду того, что СРТ является оптимальной возможностью лечения пациентов с удлиненным QRS. Обсуждаются результаты, полученные при оценке клинической эффективности и безопасности лечения больных ХСН (n=617) в рандомизированных клинических исследованиях FIX-HF-3 (n=25), FIX-HF-4 (n=164), FIX-HF-5 (n=428). Исходные характеристики пациентов были аналогичны для всех 3-х исследований. Все участники получали оптимальную медикаментозную терапию, имели нормальную длительность QRS. Все пациенты были II и III функционального класса (по NYHA). В исследованиях проводился анализ изменений функционального класса NYHA, фракции выброса, пикового потребления кислорода (VO2), предшественника мозгового натрийуретического пептида (NT-proBNP). Проводилась оценка качества жизни по результатам Миннесотского опросника, уровень смертности сравнивался с прогнозируемым по шкале MAGGIC. МСС благоприятно влияла на выживаемость и качество жизни пациентов. Однако для оценки долгосрочных эффектов от проведения МСС требуется больше данных.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хроническая сердечная недостаточность</kwd><kwd>имплантируемые устройства</kwd><kwd>модуляция сердечной сократимости</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic heart failure</kwd><kwd>implanted devices</kwd><kwd>cardiac contractility modulation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">ESC Guideline for the diagnosis and treatment of acute and chronic heart failure. European Heart Failure. 2016;37:2129-200.</mixed-citation><mixed-citation xml:lang="en">ESC Guideline for the diagnosis and treatment of acute and chronic heart failure. 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