rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2021-05-01rpcardio-2512Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯHeart Failure with Perserved Ejection Fraction Current Diagnostic and Therapeutic ApproachesХроническая сердечная недостаточность с сохраненной фракцией выброса: современное состояние проблемыhttps://orcid.org/0000-0002-8220-0350ЩендрыгинаА. А.ShchendryginaA. A.

Щендрыгина Анастасия Александровна - eLibrary SPIN: 2137-5623

Anastasia A. Shchendrygina - eLibrary SPIN: 2137-5623

a.shchendrygina@gmail.comhttps://orcid.org/0000-0002-1574-3881ЖбановК. А.ZhbanovK. A.

Жбанов Константин Александрович

Konstantin A. Zhbanov

https://orcid.org/0000-0002-9908-9476ПриваловаЕ. В.PrivalovaE. V.

Привалова Елена Витальевна

Elena V. Privalova

https://orcid.org/0000-0002-9744-9183ЮсуповаА. О.YusupovaA. O.

Юсупова Альфия Оскаровна

Alfiya O. Yusupova

https://orcid.org/0000-0002-4994-8500ДанилогорскаяЮ. А.DanilogorskayaYu. A.

Данилогорская Юлия Александровна

Yulia A. Danilogorskaya

https://orcid.org/0000-0003-4323-9671СалахееваЕ. Ю.SalakheevaE. Yu.

Салахеева Екатерина Юрьевна

Ekaterina Yu. Salakheeva

https://orcid.org/0000-0001-6201-1774СоколоваИ. Я.SokolovaI. Ya.

Соколова Ирина Яковлена

Irina Ya. Sokolova

https://orcid.org/0000-0002-5165-1204ЦацуроваС. А.TsatsurovaS. A.

Цацурова Сабина Александровна

Sabrina A. Tsatsurova

https://orcid.org/0000-0002-8669-6648АгееваА. А.AgeevaA. A.

Агеева Анастасия Алексеевна

Anastasia A. Ageeva

https://orcid.org/0000-0002-3014-6129БеленковЮ. Н.BelenkovYu. N.

Беленков Юрий Никитич

Yuri N. Belenkov

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202112072021173476483Copyright © Shchendrygina A.A., Zhbanov K.A., Privalova E.V., Yusupova A.O., Danilogorskaya Y.A., Salakheeva E.Y., Sokolova I.Y., Tsatsurova S.A., Ageeva A.A., Belenkov Y.N., 20212021Щендрыгина А.А., Жбанов К.А., Привалова Е.В., Юсупова А.О., Данилогорская Ю.А., Салахеева Е.Ю., Соколова И.Я., Цацурова С.А., Агеева А.А., Беленков Ю.Н.Shchendrygina A.A., Zhbanov K.A., Privalova E.V., Yusupova A.O., Danilogorskaya Y.A., Salakheeva E.Y., Sokolova I.Y., Tsatsurova S.A., Ageeva A.A., Belenkov Y.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/2512

Heart failure with preserved ejection fraction (HFpEF) is a syndrome associated with high morbidity and mortality rates. Little progress has been in the treatment of this condition since its introduction some 30 years ago. It's accepted that HFpEF is heterogeneous in many ways, ethologically and phenotypically. The underlying mechanisms of the syndrome are not clear. Recently, it has been shown that the diagnostic criteria for HFpEF lacks sensitivity and specificity. Novel treatment approaches, which were developed based on current HFpEF pathophysiological concepts, did not show either clinical or prognostic benefit for patients. Therefore, there is an urgent need to revise current diagnostic approaches and to further investigate the underlying mechanisms. Recently, two novel diagnostic score systems were proposed: H2PEF and HFA-PEFF. Recently, a number of phase II and III randomized control trials have been completed. Here, the authors discuss the potential novel diagnostic approaches to HFpEF and treatment perspectives.

Хроническая сердечная недостаточность с сохраненной фракцией выброса (СНсФВ) характеризуется широкой распространенностью и ассоциируется с высокой смертностью при отсутствии эффективных подходов к лечению. К настоящему времени ни один из исследованных лекарственных препаратов не показал своей способности модифицировать течение болезни. Отсутствие прогресса в лечении данного синдрома заставляет медицинское сообщество снова и снова изучать гетерогенную природу данного состояния и его патогенетические механизмы, а также пересматривать существующие диагностические подходы для СНсФВ. Сегодня сформировалось понимание того, что используемые диагностические критерии СНсФВ обладают недостаточной чувствительностью и специфичностью и могут влиять на результаты клинических исследований. В настоящее время предложены к рассмотрению новые диагностические алгоритмы, эффективность использования которых продолжает изучаться. Также поднимается ряд вопросов относительно оптимизации текущих терапевтических подходов, завершены ряд исследований по оценке новых групп препаратов у данной категории пациентов, обсуждаются дальнейшие перспективы в лечении. Все это сформировало предпосылки для анализа накопленной информации и послужило целью настоящего обзора.

хроническая сердечная недостаточностьсердечная недостаточность с сохраненной фракцией выбросаХСНСНсФВchronic heart failureheart failure with intact ejection fractionCHFHFpEFИсследование выполнено при финансовой поддержке РФФИ в рамках научного проекта № 20-315-90089, научного гранта «Клиническая и прогностическая значимость нейрегулина-1 у пациентов с хронической сердечной недостаточностью с сохраненной фракцией выброса и его взаимосвязь с маркерами оксидативного стресса, фиброза и воспаления»The study was performed with the financial support of the Russian Foundation for Basic Research within the framework of scientific project No. 20-315-90089, scientific grant “Clinical and prognostic significance of neuregulin-1 in patients with chronic heart failure with intact ejection fraction and its relationship with markers of oxidative stress, fibrosis and inflammation”ReferencesРоссийское кардиологическое общество (РКО). Хроническая сердечная недостаточность. Клинические рекомендации 2020. 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The authors declare that there are no conflicts of interest present.