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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">10.20996/1819-6446-2026-3294</article-id><article-id custom-type="edn" pub-id-type="custom">TQJIUV</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-3294</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>ASSOCIATED PROBLEMS OF CARDIOLOGY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СМЕЖНЫЕ ВОПРОСЫ КАРДИОЛОГИИ</subject></subj-group></article-categories><title-group><article-title>Takotsubo syndrome: management strategies</article-title><trans-title-group xml:lang="ru"><trans-title>Синдром такоцубо: терапевтические возможности</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-5446-3358</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдужамалова</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Abduzhamalova</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абдужамалова Наргиз Магомедгусеновна </p><p>ул Корнея Чуковского, д. 1, Москва, 108849 </p></bio><bio xml:lang="en"><p>Nargiz M. Abduzhamalova </p><p>Korney Chukovsky st.,1. Moscow, 108849 </p></bio><email xlink:type="simple">nargiz-a@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7131-8049</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мамедов</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Mamedov</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мамедов Мехман Ниязиевич </p><p>Петроверигский пер., д. 10, стр. 3, Москва, 101990 </p></bio><bio xml:lang="en"><p>Mehman N. Mamedov </p><p>Petroverigsky Lane, 10, bld. 3, Moscow, 101990 </p></bio><email xlink:type="simple">mmamedov@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ООО «СамМед»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>«SumMed» LLC</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр терапии и профилактической медицины» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center for Therapy and Preventive Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>17</day><month>06</month><year>2026</year></pub-date><volume>22</volume><issue>2</issue><fpage>185</fpage><lpage>190</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Abduzhamalova N.M., Mamedov M.N., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Абдужамалова Н.М., Мамедов М.Н.</copyright-holder><copyright-holder xml:lang="en">Abduzhamalova N.M., Mamedov M.N.</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/3294">https://www.rpcardio.online/jour/article/view/3294</self-uri><abstract><p>Takotsubo syndrome (TS) management is a complex task that requires a comprehensive and differentiated approach, taking into account various clinical scenarios and potential complications. This review analyses current strategies for TS management, covering the treatment of uncomplicated cases, management of lifethreatening complications, and assessment of longterm prognosis. In uncomplicated cases, the primary treatment goal is to stabilise the patient’s condition and relieve symptoms. Firstline medications typically include betablockers and angiotensinconverting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs). While the role of betablockers remains a subject of debate within the scientific community, ACEIs/ARBs have shown promising results in improving longterm prognosis and reducing the likelihood of recurrences. Management of patients with complicated forms of TS, particularly cardiogenic shock and intraventricular thrombosis, requires more aggressive therapeutic interventions. In cases of cardiogenic shock, it is crucial to differentiate whether left ventricular outflow tract obstruction is present, as this determines the choice of optimal inotropic support. The detection of intracardiac thrombus is an indication for anticoagulant therapy, with a recommended duration of at least three months or until full recovery of myocardial contractility. Although the overall prognosis for TS is generally favourable, with a high probability of left ventricular dysfunction regression, the risk of disease recurrence persists. To optimise longterm patient management, it is advisable to conduct not only regular monitoring of left ventricular function but also assessment of the patient’s psychoemotional state. However, the lack of conclusive evidence regarding the effectiveness of longterm pharmacological therapy in preventing disease recurrence underscores the need for further largescale studies.</p></abstract><trans-abstract xml:lang="ru"><p>Ведение пациентов с синдромом такоцубо (СТ) представляет собой сложную задачу, требующую комплексного и дифференцированного подхода, учитывающего различные клинические сценарии и потенциальные осложнения. Настоящий обзор посвящен анализу современных стратегий ведения пациентов с СТ, охватывая терапию неосложненного течения, купирование жизнеугрожающих осложнений и оценку долгосрочного прогноза. В случае неосложненного течения заболевания, основная цель лечения — стабилизация состояния и купирование симптомов. В качестве препаратов первой линии, как правило, используются бета-блокаторы и ингибиторы ангиотензинпревращающего фермента (иАПФ) или блокаторы рецепторов ангиотензина II (БРА). В отличие от бета-блокаторов, роль которых остается предметом дискуссий в научном сообществе, иАПФ/БРА демонстрируют многообещающие результаты в плане улучшения долгосрочного прогноза и снижения вероятности рецидивов.Ведение пациентов с осложненными формами СТ, в частности с кардиогенным шоком и внутрижелудочковым тромбозом, требует более агрессивных лечебных вмешательств. При кардиогенном шоке решающее значение имеет дифференциация наличия обструкции выносящего тракта левого желудочка, что определяет выбор оптимальной инотропной поддержки. Выявление внутрижелудочкового тромбоза является показанием к назначению антикоагулянтной терапии, рекомендуемая продолжительность которой составляет не менее 3 мес. или до полного восстановления сократительной способности миокарда.Несмотря на то, что прогноз при СТ в целом благоприятный, с высокой вероятностью регрессии дисфункции левого желудочка, риск развития рецидива заболевания сохраняется. Для оптимизации долгосрочного ведения пациентов целесообразно проводить не только регулярный мониторинг функции левого желудочка, но и оценку психоэмоционального состояния. Вместе с тем, отсутствие неоспоримых доказательств эффективности долгосрочной медикаментозной терапии в профилактике рецидива заболевания подчеркивает необходимость проведения дальнейших крупномасштабных исследований.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>синдром такоцубо</kwd><kwd>стресс-индуцированная кардиомиопатия</kwd><kwd>синдром разбитого сердца</kwd><kwd>синдром счастливого сердца</kwd><kwd>неишемическая кардиомиопатия</kwd><kwd>прогноз</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Takotsubo syndrome</kwd><kwd>stress-induced cardiomyopathy</kwd><kwd>broken heart syndrome</kwd><kwd>happy heart syndrome</kwd><kwd>nonischemic cardiomyopathy</kwd><kwd>prognosis</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">Ghadri JR, Wittstein IS, Prasad A, et al. 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