rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2017-13-4-482-488rpcardio-1508Research ArticleNOTES FROM PRACTICEКЛИНИЧЕСКИЙ ОПЫТPATIENT WITH CHRONIC HEART FAILURE. RATIONAL CHOICE OF THERAPYПАЦИЕНТ С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ. ВЫБОР ОПТИМАЛЬНОЙ ТЕРАПИИДрапкинаО. М.DrapkinaO. M.

д.м.н., профессор, член-корреспондент РАН, и.о. директора,

101990, Москва, Петроверигский пер., 10, стр. 3

MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Acting Director,

Petroverigsky per. 10-3, Moscow, 101990

АкашеваД. У.AkashevaD. U.

к.м.н., в.н.с. отдела фундаментальных и прикладных аспектов ожирения,

101990, Москва, Петроверигский пер., 10, стр. 3

MD, PhD, Leading Researcher, Department of Fundamental and Applied Aspects of Obesity,

Petroverigsky per. 10-3, Moscow, 101990

dariga-akasheva@yandex.ruНациональный медицинский исследовательский центр профилактической медициныРоссияNational Medical Research Center for Preventive MedicineRussian Federation201703092017134482488Copyright © Drapkina O.M., Akasheva D.U., 20172017Драпкина О.М., Акашева Д.У.Drapkina O.M., Akasheva D.U.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1508

The theory of chronic hyperactivation of neurohormonal systems, in particular, sympathoadrenal and renin-angiotensin-aldosterone, is the basis of modern concepts of the pathogenesis of heart failure. The medicinal blocking of these two systems has proved to be effective in the treatment of heart failure with reduced ejection fraction (<40%). Antagonists of mineralocorticoid receptors, along with angiotensin-converting enzyme inhibitors and beta-blockers, are neurohumoral modulators. They are used to treat patients with heart failure with reduced ejection fraction. The prescription of mineralocorticoid receptor antagonists in clinical practice remains insufficient despite their high efficacy. Demonstration of the site of mineralocorticoid receptor antagonists in the complex treatment of a patient with chronic heart failure and diabetes type 2 is the goal of this article.

В основе современных представлений о патогенезе сердечной недостаточности лежит теория хронической гиперактивации нейрогормональных систем, в частности, симпатоадреналовой и ренин-ангиотензин-альдостероновой. Медикаментозное блокирование этих двух систем доказало свою эффективность в лечении сердечной недостаточности с низкой фракцией выброса левого желудочка (<40%). Антагонисты минералокортикоидных рецепторов, наряду с ингибиторами ангиотензинпревращающего фермента и бета-адреноблокаторами, являются нейрогуморальными модуляторами, применяемыми для лечения данной категории пациентов с сердечной недостаточностью. Несмотря на высокую эффективность антагонистов минералокортикоидных рецепторов, их назначение в клинической практике остается недостаточным. Цель данной статьи – показать место антагонистов минералокортикоидных рецепторов в комплексном лечении пациента с хронической сердечной недостаточностью и сахарным диабетом 2 типа.

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The authors declare that there are no conflicts of interest present.