rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2021-04-05rpcardio-2445Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИManagement of Patients with Chronic Heart Failure and Diabetes MellitusОсобенности ведения больных с хронической сердечной недостаточностью и сахарным диабетомhttps://orcid.org/0000-0001-7479-418XРезникЕ. В.ReznikE. V.

Резник Елена Владимировна – eLibrary SPIN 3494-9080

Москва

Elena V. Reznik - eLibrary SPIN 3494-9080

Moscow

elenaresnik@gmail.comhttps://orcid.org/0000-0002-8856-4542НгуенТ. Л.NguyenT. L.

Нгуен Тхань Луан

Москва

Nguyen Thanh Luan

Moscow

https://orcid.org/0000-0002-0161-005XГолуховГ. Н.GolukhovG. N.

Голухов Георгий Натанович – eLibrary SPIN 5414-2026

Москва

George N. Golukhov - eLibrary SPIN 5414-2026

Moscow

Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Городская клиническая больница имени В.М. Буянова; Городская клиническая больница №31РоссияRussian National Research Medical University n.a. N.I. Pirogov; City Clinical Hospital n.a. V.M. Buyanov; City Clinical Hospital №31Russian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияRussian National Research Medical University n.a. N.I. PirogovRussian FederationГородская клиническая больница №31РоссияCity Clinical Hospital №31Russian Federation202107052021172341350Copyright © Reznik E.V., Nguyen T.L., Golukhov G.N., 20212021Резник Е.В., Нгуен Т.Л., Голухов Г.Н.Reznik E.V., Nguyen T.L., Golukhov G.N.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/2445

Chronic heart failure (CHF) occurs in 4.3-28% of patients with diabetes mellitus and is most often associated with the presence of coronary heart disease, arterial hypertension and the direct adverse effects of insulin-resistance, hyperinsulinemia and hyperglycemia on the myocardium. Diabetes mellitus occurs in 12-47% of patients with CHF and can develop within several years after a diagnosis of HF in 22% of patients due to insulin-resistance of failure tissues. The presence of diabetes mellitus leads to a greater severity of clinical symptoms and hospitalization rate, worsening of quality of life and prognosis in CHF. A decreased left ventricular ejection fraction is an independent predictor of the poor prognosis in the patients with diabetes mellitus. The algorithm of the treatment of CHF in the patients with and without diabetes mellitus is not fundamentally different, but it requires taking into account the metabolic effects of the prescribed drugs. Angiotensin receptor-neprilysin inhibitor are increasingly used in clinical practice and are gradually replacing angiotensin-converting enzyme inhibitors and sartans in CHF both without diabetes mellitus and in its presence. Recently, the effectiveness of type 2 sodium glucose cotransporter inhibitors has been proven in patients with CHF with and without diabetes mellitus. This review is devoted to the relationship of diabetes mellitus and CHF, as well as the approaches to the management of such comorbid patients.

Хроническая сердечная недостаточность (ХСН) встречается у 4,3-28% пациентов с сахарным диабетом и обусловлена ишемической болезнью сердца, артериальной гипертонией и прямым неблагоприятным влиянием инсулинорезистентности, гиперинсулинемии и гипергликемии на миокард. Сахарный диабет встречается у 12-47% больных с ХСН. Он развивается в течение нескольких лет после постановки диагноза ХСН у 22% пациентов в связи с развитием инсулинорезистентности на фоне ухудшения кровоснабжения тканей. У больных с ХСН наличие сахарного диабета приводит к большей выраженности клинической симптоматики, учащению госпитализаций, ухудшению качества жизни и прогноза. У больных с сахарным диабетом снижение фракции выброса левого желудочка является независимым предиктором неблагоприятного прогноза. Алгоритм лечения ХСН у пациентов с/без сахарного диабета принципиально не отличается, но требует учета метаболических эффектов назначаемых препаратов. Ингибиторы ангиотензиновых рецепторов и неприлизина все чаще используются в клинической практике и постепенно вытесняют ингибиторы ангиотензинпревращающего фермента и сартаны при ХСН как без сахарного диабета, так и при его наличии. Недавно была доказана эффективность ингибиторов натрий-глюкозного котранспортера 2-го типа у больных с ХСН с сахарным диабетом и без него. Обзор посвящен проблеме взаимосвязи сахарного диабета и ХСН, а также ведению таких коморбидных пациентов.

хроническая сердечная недостаточностьсахарный диабетфракция выброса левого желудочкамедикаментозная терапияингибитор ангиотензиновых рецепторов и неприлизинаSGLT2натрий-глюкозный котранспортер 2-го типаchronic heart failurediabetes mellitusleft ventricular ejection fractionpharmacotherapyangiotensin receptor-neprilysin inhibitorSGLT-2sodium-glucose cotransporter-2ReferencesSeferovic PM, Petrie MC, Filippatos GS, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(5):853-72. DOI:10.1002/ejhf.1170.Seferovic PM, Petrie MC, Filippatos GS, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(5):853-72. DOI:10.1002/ejhf.1170.GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Prevalence, Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-1259. DOI:10.1016/S0140-6736(17)32154-2.GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Prevalence, Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-1259. DOI:10.1016/S0140-6736(17)32154-2.van Riet EE, Hoes AW, Wagenaar KP, et al. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18(3):242-52. DOI:10.1002/ejhf.483.van Riet EE, Hoes AW, Wagenaar KP, et al. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18(3):242-52. DOI:10.1002/ejhf.483.Cho NH, Shaw JE, Karuranga S, et al., IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81. DOI:10.1016/j.dia-bres.2018.02.023.Cho NH, Shaw JE, Karuranga S, et al., IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81. DOI:10.1016/j.dia-bres.2018.02.023.Фомин И.В., Хроническая сердечная недостаточность в Российской Федерации: что сегодня мы знаем и что должны делать. Российский Кардиологический Журнал. 2016;8:7-13. DOI:10.15829/1560-4071-2016-8-7-13.Fomin I.V. Chronic Heart Failure in Russian Federation: What Do We Know and What To Do. Russian Journal of Cardiology. 2016;(8):7-13 (In Russ.) DOI:10.15829/1560-4071-2016-8-7-13.Reznik EV, Presnova ED, Lazarev VA. Cardiorenal syndrome in patients with chronic heart failure and type 2 diabetes mellitus. Nephrology Dialysis Transplantation. 2018;33 Issue suppl_1:i1-i660. DOI:10.1093/ndt/gfy104.Reznik EV, Presnova ED, Lazarev VA. Cardiorenal syndrome in patients with chronic heart failure and type 2 diabetes mellitus. Nephrology Dialysis Transplantation. 2018;33 Issue suppl_1:i1-i660. DOI:10.1093/ndt/gfy104.Nichols GA, Gullion CM, Koro CE, et al. The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care. 2004;27(8):1879-84. DOI:10.2337/diacare.27.8.1879.Nichols GA, Gullion CM, Koro CE, et al. The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care. 2004;27(8):1879-84. DOI:10.2337/diacare.27.8.1879.Demant MN, Gislason GH, Kober L, et al. Association of heart failure severity with risk of diabetes: a Danish nationwide cohort study. Diabetologia. 2014;57(8):1595-600. DOI:10.1007/s00125-014-3259-z.Demant MN, Gislason GH, Kober L, et al. Association of heart failure severity with risk of diabetes: a Danish nationwide cohort study. Diabetologia. 2014;57(8):1595-600. DOI:10.1007/s00125-014-3259-z.Rawshani A, Rawshani A, Franzen S, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;379(7):633-44. DOI:10.1056/NEJMoa1800256.Rawshani A, Rawshani A, Franzen S, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;379(7):633-44. DOI:10.1056/NEJMoa1800256.Ларина В.Н., Вартанян Е.А, Барт Б.Я., и др. Сердечная недостаточность: актуальные вопросы диагностики, лечения и профилактики с позиций доказательной медицины. Москва: РНИМУ им.Н.И.Пирогова, 2020.Larina VN, Vartanyan EA, Bart BYa, et al. Heart failure: topical issues of diagnosis, treatment and prevention from the standpoint of evidence-based medicine. Moscow: Pirogov Russian National Research Medical University, 2020 (In Russ.)Дедов И.И., Шестакова М.В., Майоров А.Ю. Алгоритмы специализированной медицинской помощи больным сахарным диабетом -8-й выпуск. Сахарный Диабет. 2017;20(1S):1-121.Dedov II, Shestakova MV, Mayorov AYu. Algorithms for specialized medical care for patients with diabetes mellitus - 8th edition. Diabetes. 2017; 20 (1S): 1-121 (In Russ.)Butler J, Januzzi JL, Rosenstock J. Management of heart failure and type 2 diabetes mellitus: Maximizing complementary drug therapy. Diabetes Obes Metab. 2020;22(8):1243-62. DOI:10.1111/dom.14042.Butler J, Januzzi JL, Rosenstock J. Management of heart failure and type 2 diabetes mellitus: Maximizing complementary drug therapy. Diabetes Obes Metab. 2020;22(8):1243-62. DOI:10.1111/dom.14042.Bertoni AG, Hundley WG, Massing MW. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care. 2004;27(3):699-703. DOI:10.2337/diacare.27.3.699.Bertoni AG, Hundley WG, Massing MW. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care. 2004;27(3):699-703. DOI:10.2337/diacare.27.3.699.Dei Cas A, Fonarow GC, Gheorghiade M, et al. Concomitant diabetes mellitus and heart failure. Curr Probl Cardiol. 2015;40(1):7-43 DOI:10.1016/j.cpcardiol.2014.09.002.Dei Cas A, Fonarow GC, Gheorghiade M, et al. Concomitant diabetes mellitus and heart failure. Curr Probl Cardiol. 2015;40(1):7-43 DOI:10.1016/j.cpcardiol.2014.09.002.Кобалава Ж.Д., Ешниязов Н.Б., Медовщиков В.В., Хасанова Э.Р. Сахарный диабет 2 го типа и сердечная недостаточность: инновационные возможности управления прогнозом. Кар-диология. 2019;59(4):76-87. DOI:10.18087/cardio.2019.4.10253.Kobalava ZD, Yeshniyazov NV, Medovchshikov VV, Khasanova ER. Type 2 Diabetes Mellitus and Heart Failure: Innovative Possibilities for Management of Prognosis. Kardiologiia. 2019;59(4):76-87 (In Russ.) DOI:10.18087/cardio.2019.4.10253.Резник Е.В., Никитин И.Г. Кардиоренальный синдром у больных с сердечной недостаточностью как этап кардиоренального континуума (часть II): прогностическое значение, профилактика и лечение (обзор литературы). Архив Внутренней Медицины. 2019;2(46):93-107.Reznik EV, Nikitin IG. Cardiorenal syndrome in patients with heart failure as a stage of the cardiorenal continuum (part II): prognostic value, prevention and treatment (literature review). Archive of Internal Medicine. 2019;2(46):93-107 (In Russ.)Резник Е.В., Никитин И.Г. Кардиоренальный синдром у больных с сердечной недостаточностью как этап кардиоренального континуума (часть I): определение, классификация, патогенез, диагностика, эпидемиология (обзор литературы). Архив Внутренней Медицины. 2019;1(45):5-22.Reznik EV, Nikitin IG. Cardiorenal syndrome in patients with heart failure as a stage of the cardiorenal continuum (Part I): definition, classification, pathogenesis, diagnosis, epidemiology (literature review). Archive of Internal Medicine. 2019;1(45):5-22 (In Russ.)Lundbaek K. Diabetic angiopathy: a specific vascular disease. Lancet. 1954;266(6808):377-9. DOI:10.1016/s0140-6736(54)90924-1.Lundbaek K. Diabetic angiopathy: a specific vascular disease. Lancet. 1954;266(6808):377-9. DOI:10.1016/s0140-6736(54)90924-1.Tadic M, Cuspidi C, Calicchio F, et al. Diabetic cardiomyopathy: How can cardiac magnetic resonance help? Acta Diabetol. 2020;57(9):1027-34. DOI:10.1007/s00592-020-01528-2.Tadic M, Cuspidi C, Calicchio F, et al. Diabetic cardiomyopathy: How can cardiac magnetic resonance help? Acta Diabetol. 2020;57(9):1027-34. DOI:10.1007/s00592-020-01528-2.Maack C, Lehrke M, Backs J, et al. Heart failure and diabetes: metabolic alterations and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Failure Association-European Society of Cardiology. Eur Heart J. 2018;39(48):4243-54. DOI:10.1093/eu-rheartj/ehy596.Maack C, Lehrke M, Backs J, et al. Heart failure and diabetes: metabolic alterations and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Failure Association-European Society of Cardiology. Eur Heart J. 2018;39(48):4243-54. DOI:10.1093/eu-rheartj/ehy596.Sattar N, McLaren J, Kristensen SL, et al. SGLT2 Inhibition and cardiovascular events: why did EMPA- REG Outcomes surprise and what were the likely mechanisms? Diabetologia. 2016;59(7):1333-9.DOI:10.1007/s00125-016-3956-x.Sattar N, McLaren J, Kristensen SL, et al. SGLT2 Inhibition and cardiovascular events: why did EMPA- REG Outcomes surprise and what were the likely mechanisms? Diabetologia. 2016;59(7):1333-9.DOI:10.1007/s00125-016-3956-x.Abdul-Ghani MA, Norton L, DeFronzo RA. Renal sodium-glucose cotransporter inhibition in the management of type 2 diabetes mellitus. Am J Physiol Renal Physiol. 2015;309(11):F889-900. DOI:10.1152/ajprenal.00267.2015.Abdul-Ghani MA, Norton L, DeFronzo RA. Renal sodium-glucose cotransporter inhibition in the management of type 2 diabetes mellitus. Am J Physiol Renal Physiol. 2015;309(11):F889-900. DOI:10.1152/ajprenal.00267.2015.Seferovic PM, Paulus WJ. Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes. Eur Heart J. 2015;36(27):1718-27. DOI:10.1093/eurheartj/ehv134.Seferovic PM, Paulus WJ. Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes. Eur Heart J. 2015;36(27):1718-27. DOI:10.1093/eurheartj/ehv134.Paulus WJ, Tschope C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263-71. DOI:10.1016/j.jacc.2013.02.092.Paulus WJ, Tschope C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263-71. DOI:10.1016/j.jacc.2013.02.092.De Keulenaer GW, Brutsaert DL. Systolic and diastolic heart failure are overlapping phenotypes within the heart failure spectrum. Circulation. 2011;123(18):1996-2004. DOI:10.1161/CIRCULATION-AHA.110.981431.De Keulenaer GW, Brutsaert DL. Systolic and diastolic heart failure are overlapping phenotypes within the heart failure spectrum. Circulation. 2011;123(18):1996-2004. DOI:10.1161/CIRCULATION-AHA.110.981431.Poulsen MK, Henriksen JE, Dahl J, et al. Left ventricular diastolic function in type 2 diabetes mellitus: prevalence and association with myocardial and vascular disease. Circ Cardiovasc Imaging, 2010;3(1):24-31. DOI:10.1161/CIRCIMAGING.109.855510.Poulsen MK, Henriksen JE, Dahl J, et al. Left ventricular diastolic function in type 2 diabetes mellitus: prevalence and association with myocardial and vascular disease. Circ Cardiovasc Imaging, 2010;3(1):24-31. DOI:10.1161/CIRCIMAGING.109.855510.Packer M. Epicardial Adipose Tissue May Mediate Deleterious Effects of Obesity and Inflammation on the Myocardium. J Am Coll Cardiol. 2018;71(20):2360-72. DOI:10.1016/j.jacc.2018.03.509.Packer M. Epicardial Adipose Tissue May Mediate Deleterious Effects of Obesity and Inflammation on the Myocardium. J Am Coll Cardiol. 2018;71(20):2360-72. DOI:10.1016/j.jacc.2018.03.509.Russo I, Frangogiannis NG. Diabetes-associated cardiac fibrosis: Cellular effectors, molecular mechanisms and therapeutic opportunities. J Mol Cell Cardiol. 2016;90:84-93. DOI:10.1016/j.yjmcc.2015.12.011.Russo I, Frangogiannis NG. Diabetes-associated cardiac fibrosis: Cellular effectors, molecular mechanisms and therapeutic opportunities. J Mol Cell Cardiol. 2016;90:84-93. DOI:10.1016/j.yjmcc.2015.12.011.van Heerebeek L, Hamdani N, Handoko ML, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117(1):43-51. DOI:10.1161/CIRCULATIONAHA.107.728550.van Heerebeek L, Hamdani N, Handoko ML, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117(1):43-51. DOI:10.1161/CIRCULATIONAHA.107.728550.Резник Е.В., Лазарев В.А., Калова М.Р., Никитин И.Г. Ведение больных с хронической сердечной недостаточностью и сахарным диабетом с позиций современных рекомендаций и в реальной клинической практике. Consilium Medicum. 2020;22(5):50-6. DOI:10.26442/20751753.2020.5.200198Reznik EV, Lazarev VA, Kalova MR, Nikitin IG. Management of patients with chronic heart failure and diabetes mellitus from the standpoint of modern recommendations and in real clinical practice. Consilium Medicum. 2020;22(5):50-6. DOI:10.26442/20751753.2020.5.200198 (In Russ.) DOI:10.26442/20751753.2020.5.200198Seferovic PM, Ponikowski P, Anker SD, et al. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019. DOI:10.1002/ejhf.1531.Seferovic PM, Ponikowski P, Anker SD, et al. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019. DOI:10.1002/ejhf.1531.Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891-975. DOI:10.1002/ejhf.592.Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891-975. DOI:10.1002/ejhf.592.Моисеев В.С., Мухин Н.А., Смирнов А.В. Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Российский Кардиологический Журнал. 2014;(8):7-37. DOI:10.15829/1560-4071-2014-8-7-37.Moiseev VC, Mukhin NA, Smirnov AV, et al. Cardiovascular Risk and Chronic Kidney Disease: Car- dio-Nephroprotection Strategies. Russian Journal of Cardiology. 2014;(8):7-37 (In Russ.) DOI:10.15829/1560-4071-2014-8-7-37.Samuelsson O, Hedner T, Berglund G, et al. Diabetes mellitus in treated hypertension: incidence, predictive factors and the impact of non-selective beta-blockers and thiazide diuretics during 15 years treatment of middle-aged hypertensive men in the Primary Prevention Trial Goteborg, Sweden. J Hum Hypertens. 1994;8(4):257-63.Samuelsson O, Hedner T, Berglund G, et al. Diabetes mellitus in treated hypertension: incidence, predictive factors and the impact of non-selective beta-blockers and thiazide diuretics during 15 years treatment of middle-aged hypertensive men in the Primary Prevention Trial Goteborg, Sweden. J Hum Hypertens. 1994;8(4):257-63.Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000;342(13):905- 12. DOI:10.1056/NEJM200003303421301.Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000;342(13):905- 12. DOI:10.1056/NEJM200003303421301.Pollare T, Lithell H, Morlin C, et al. Metabolic effects of diltiazem and atenolol: results from a randomized, double-blind study with parallel groups. J Hypertens, 1989;7(7):551-9. DOI:10.1097/00004872-198907000-00006.Pollare T, Lithell H, Morlin C, et al. Metabolic effects of diltiazem and atenolol: results from a randomized, double-blind study with parallel groups. J Hypertens, 1989;7(7):551-9. DOI:10.1097/00004872-198907000-00006.Pollare T, Lithell H, Selinus I, et al. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients. BMJ. 1989;298(6681):1152-7. DOI:10.1136/bmj.298.6681.1152.Pollare T, Lithell H, Selinus I, et al. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients. BMJ. 1989;298(6681):1152-7. DOI:10.1136/bmj.298.6681.1152.Torp-Pedersen C, Metra M, Charlesworth A, et al. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the Carvedilol Or Metoprolol European Trial (COMET). Heart. 2007;93(8):968-73. DOI:10.1136/hrt.2006.092379.Torp-Pedersen C, Metra M, Charlesworth A, et al. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the Carvedilol Or Metoprolol European Trial (COMET). Heart. 2007;93(8):968-73. DOI:10.1136/hrt.2006.092379.Ladage D, Schwinger RH, Brixius K. Cardio-selective beta-blocker: pharmacological evidence and their influence on exercise capacity. Cardiovasc Ther, 2013;31(2):76-83. DOI:10.1111/j.1755-5922.2011.00306.x.Ladage D, Schwinger RH, Brixius K. Cardio-selective beta-blocker: pharmacological evidence and their influence on exercise capacity. Cardiovasc Ther, 2013;31(2):76-83. DOI:10.1111/j.1755-5922.2011.00306.x.Мареев Ю.В., Мареев В.Ю. Характеристика и лечение пациентов с ХСН, госпитализированных в стационар. Кардиология. 2017;57(4S):19-30. DOI:10.18087/cardio.2433.Mareev YuV, Mareev VYu. Characteristics and treatment of hospitalized patients with CHF. Kardi- ologiia. 2017;57(4S):19-30 (In Russ.) DOI:10.18087/cardio.2433.Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709-17. DOI:10.1056/NEJM199909023411001.Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709-17. DOI:10.1056/NEJM199909023411001.Zannad F, McMurray JJ, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011;364(1):11-21. DOI:10.1056/NEJMoa1009492.Zannad F, McMurray JJ, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011;364(1):11-21. DOI:10.1056/NEJMoa1009492.Dei Cas A, Khan SS, Butler J, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail. 2015;3(2):136-45. DOI:10.1016/j.jchf.2014.08.004.Dei Cas A, Khan SS, Butler J, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail. 2015;3(2):136-45. DOI:10.1016/j.jchf.2014.08.004.Nicolas D, Kerndt CC, Reed M. Sacubitril/Valsartan. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507904/.Nicolas D, Kerndt CC, Reed M. Sacubitril/Valsartan. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507904/.Seferovic JP, Claggett B, Seidelmann SB, et al. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM- HF trial. Lancet Diabetes & Endocrinology. 2017;5(5):333-40. DOI:10.1016/S2213-8587(17)30087-6.Seferovic JP, Claggett B, Seidelmann SB, et al. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM- HF trial. Lancet Diabetes & Endocrinology. 2017;5(5):333-40. DOI:10.1016/S2213-8587(17)30087-6.Solomon SD, Rizkala AR, Lefkowitz MP, et al. Baseline Characteristics of Patients With Heart Failure and Preserved Ejection Fraction in the PARAGON-HF Trial. Circ Heart Fail. 2018;11(7):e004962. DOI:10.1161/CIRCHEARTFAILURE.118.004962.Solomon SD, Rizkala AR, Lefkowitz MP, et al. Baseline Characteristics of Patients With Heart Failure and Preserved Ejection Fraction in the PARAGON-HF Trial. Circ Heart Fail. 2018;11(7):e004962. DOI:10.1161/CIRCHEARTFAILURE.118.004962.Senni M, Wachter R, Witte KK, et al. Initiation of sacubitril/valsartan shortly after hospitalisation for acutely decompensated heart failure in patients with newly diagnosed (de novo) heart failure: a subgroup analysis of the TRANSITION study. Eur J Heart Fail. 2020;22(2):303-12. DOI:10.1002/ejhf.1670.Senni M, Wachter R, Witte KK, et al. Initiation of sacubitril/valsartan shortly after hospitalisation for acutely decompensated heart failure in patients with newly diagnosed (de novo) heart failure: a subgroup analysis of the TRANSITION study. Eur J Heart Fail. 2020;22(2):303-12. DOI:10.1002/ejhf.1670.Pascual-Figal D, Wachter R, Senni M, et al. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study. JACC Heart Fail. 2020;8(10):822-33. DOI:10.1016/j.jchf.2020.05.012.Pascual-Figal D, Wachter R, Senni M, et al. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study. JACC Heart Fail. 2020;8(10):822-33. DOI:10.1016/j.jchf.2020.05.012.Wachter R, Senni M, Belohlavek J, et al. Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study. Eur J Heart Fail. 2019;21(8):998-1007. DOI:10.1002/ejhf.1498.Wachter R, Senni M, Belohlavek J, et al. Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study. Eur J Heart Fail. 2019;21(8):998-1007. DOI:10.1002/ejhf.1498.Pascual-Figal D, Wachter R, Senni M, et al. Rationale and design of TRANSITION: a randomized trial of pre-discharge vs. post-discharge initiation of sacubitril/valsartan. ESC Heart Failure. 2018;5(2):327-36. DOI:10.1002/ehf2.12246.Pascual-Figal D, Wachter R, Senni M, et al. Rationale and design of TRANSITION: a randomized trial of pre-discharge vs. post-discharge initiation of sacubitril/valsartan. ESC Heart Failure. 2018;5(2):327-36. DOI:10.1002/ehf2.12246.Velazquez EJ, Morrow DA, DeVore AD, et al. Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial. Am Heart J. 2018;198:145-51. DOI:10.1016/j.ahj.2018.01.004.Velazquez EJ, Morrow DA, DeVore AD, et al. Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial. Am Heart J. 2018;198:145-51. DOI:10.1016/j.ahj.2018.01.004.Available from: http://cr.rosminzdrav.ru/#!/recomend/134 (In Russ.) [Терещенко С.Н., Галявич А.С., Агеев Ф.Т., и др. Хроническая сердечная недостаточность. Клинические рекомендации (2020). Доступно из: http://cr.rosminzdrav.ru/#!/recomend/134].Available from: http://cr.rosminzdrav.ru/#!/recomend/134 (In Russ.)Мареев ЮВ, Фомин ИВ, Агеев ФТ и др. Клинические рекомендации ОССН-РКО- РНМОТ. Сердечная недостаточность: хроническая (ХСН) и острая декомпенсированная (ОДСН). Диагностика, профилактика и лечение. Кардиология. 2018;58(6S):8-158. DOI:10.18087/cardio.2475.Mareev VYu, Fomin IV, Ageev FT, et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia. 2018;58(6S):8- 158 (In Russ.) DOI:10.18087/cardio.2475.Grant PJ, Cosentino F. The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: New features and the 'Ten Commandments' of the 2019 Guidelines are discussed by Professor Peter J. Grant and Professor Francesco Cosentino, the Task Force chairmen. Eur Heart J. 2019;40(39):3215-7. DOI:10.1093/eurheartj/ehz687.Grant PJ, Cosentino F. The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: New features and the 'Ten Commandments' of the 2019 Guidelines are discussed by Professor Peter J. Grant and Professor Francesco Cosentino, the Task Force chairmen. Eur Heart J. 2019;40(39):3215-7. DOI:10.1093/eurheartj/ehz687.Lamanna C, Monami M, Marchionni N, et al. Effect of metformin on cardiovascular events and mortality: a meta-analysis of randomized clinical trials. Diabetes, obesity & metabolism. 2011;13(3):221-8. DOI:10.1111/j.1463-1326.2010.01349.x.Lamanna C, Monami M, Marchionni N, et al. Effect of metformin on cardiovascular events and mortality: a meta-analysis of randomized clinical trials. Diabetes, obesity & metabolism. 2011;13(3):221-8. DOI:10.1111/j.1463-1326.2010.01349.x.Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):854-65.Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):854-65.Evans JM, Ogston SA, Emslie-Smith A, et al. Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin. Diabetologia. 2006;49(5):930-6. DOI:10.1007/s00125-006-0176-9.Evans JM, Ogston SA, Emslie-Smith A, et al. Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin. Diabetologia. 2006;49(5):930-6. DOI:10.1007/s00125-006-0176-9.Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323. DOI:10.1093/eurheartj/ehz486.Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323. DOI:10.1093/eurheartj/ehz486.Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-28. DOI:10.1056/NEJMoa1504720.Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-28. DOI:10.1056/NEJMoa1504720.Fitchett D, Zinman B, Wanner C, et al. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME(R) trial. Eur Heart J. 2016;37(19):1526-34. DOI:10.1093/eurheartj/ehv728.Fitchett D, Zinman B, Wanner C, et al. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME(R) trial. Eur Heart J. 2016;37(19):1526-34. DOI:10.1093/eurheartj/ehv728.Mahaffey KW, Neal B, Perkovic V, et al. Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). Circulation. 2018;137(4):323-34. DOI:10.1161/CIRCULATIONAHA.117.032038.Mahaffey KW, Neal B, Perkovic V, et al. Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). Circulation. 2018;137(4):323-34. DOI:10.1161/CIRCULATIONAHA.117.032038.Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-57. DOI:10.1056/NEJMoa1812389.Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-57. DOI:10.1056/NEJMoa1812389.Brito D, Bettencourt P, Carvalho D, et al. Sodium-Glucose Co-transporter 2 Inhibitors in the Failing Heart: a Growing Potential. Cardiovasc Drugs Ther. 2020;34(3):419-36. DOI:10.1007/s10557-020-06973-3.Brito D, Bettencourt P, Carvalho D, et al. Sodium-Glucose Co-transporter 2 Inhibitors in the Failing Heart: a Growing Potential. Cardiovasc Drugs Ther. 2020;34(3):419-36. DOI:10.1007/s10557-020-06973-3.Verma S, McMurray JJV. SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the- art review. Diabetologia. 2018;61(10):2108-17. DOI:10.1007/s00125-018-4670-7.Verma S, McMurray JJV. SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the- art review. Diabetologia. 2018;61(10):2108-17. DOI:10.1007/s00125-018-4670-7.Patel DK, Strong J. The Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Beyond the Glycemic Benefit. Diabetes Therapy. 2019;10(5):1771-92. DOI:10.1007/s13300-019-00686-z.Patel DK, Strong J. The Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Beyond the Glycemic Benefit. Diabetes Therapy. 2019;10(5):1771-92. DOI:10.1007/s13300-019-00686-z.Solomon SD, Jhund PS, Claggett BL, et al. Effect of Dapagliflozin in Patients With HFrEF Treated With Sacubitril/Valsartan: The DAPA-HF Trial. JACC Heart Fail. 2020;8(10):811-8. DOI:10.1016/j.jchf.2020.04.008.Solomon SD, Jhund PS, Claggett BL, et al. Effect of Dapagliflozin in Patients With HFrEF Treated With Sacubitril/Valsartan: The DAPA-HF Trial. JACC Heart Fail. 2020;8(10):811-8. DOI:10.1016/j.jchf.2020.04.008.Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383(15):1413-24. DOI:10.1056/NEJMoa2022190.Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383(15):1413-24. DOI:10.1056/NEJMoa2022190.

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