mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2024-15-4-38-48mvjr-1985Research ArticleКАРДИОЛОГИЯCARDIOLOGYПредикторы неблагоприятного течения и прогноза у пациентов с сердечной недостаточностью с сохраненной фракцией выброса левого желудочкаPredictors of unfavorable progression and prognosis in patients with heart failure with preserved left ventricular ejection fractionhttps://orcid.org/0009-0006-7641-5191СоболевскаяМ. С.SobolevskayaM. S.

Соболевская Мария Сергеевна, лаборант-исследователь отдела амбулаторных лечебно-диагностических технологий Института Клинической Кардиологии им. А.Л. Мясникова

Москва

Maria S. Sobolevskaya, Laboratory Assistant-Researcher, Department of Outpatient Treatment and Diagnostic Technologies, A.L. Myasnikov Institute of Clinical Cardiology

Moscow

msobolevskaya95@mail.ruhttps://orcid.org/0000-0002-5684-9842ГвоздеваА. Д.GvozdevaA. D.

Гвоздева Анна Дмитриевна, к.м.н. врач функциональной диагностики

Москва

Anna D. Gvozdeva, Cand. Sci. (Med.), functional diagnostics doctor

Moscow

gvozgevaannalech@gmail.comhttps://orcid.org/0000-0003-1317-036XСвиридаО. Н.SviridaO. N.

Свирида Ольга Николаевна, к.м.н., младший научный сотрудник лаборатории фиброза миокарда и сердечной недостаточности с сохранённой фракцией выброса Института Клинической Кардиологии им. А.Л. Мясникова, научный сотрудник отдела амбулаторных лечебно-диагностических технологий Института Клинической Кардиологии им. А.Л. Мясникова

Москва

 

Olga N. Svirida, Cand. Sci. (Med.), junior researcher, Laboratory of Myocardial Fibrosis and Heart Failure with Preserved Ejection Fraction of the A.L. Myasnikov Institute of Clinical Cardiology, Researcher of the Department of Outpatient Treatment and Diagnostic Technologies of the A.L. Myasnikov Institute of Clinical Cardiology

Moscow

olgasvirida@yandex.ruhttps://orcid.org/0000-0001-8911-1628ФилатоваА. Ю.FilatovaA. Y.

Филатова Анастасия Юрьевна, к.м.н., научный сотрудник лаборатории фиброза миокарда и сердечной недостаточности с сохранённой фракцией выброса Института Клинической Кардиологии им. А.Л. Мясникова, научный сотрудник лаборатории клеточной иммунологии Института Экспериментальной Кардиологии им. ак. В.Н. Смирнова

Москва

Anastasiia Y. Filatova, Cand. Sci. (Med.), researcher of Laboratory of Myocardial Fibrosis and Heart Failure with Preserved Ejection Fraction of the A.L. Myasnikov Institute of Clinical Cardiology, researcher of Laboratory of Cell Immunology of the ac. V.N. Smirnov Institute of Experimental Cardiology

Moscow

anastasia.m088@yandex.ruНациональный медицинский исследовательский центр кардиологии им. ак. Е.И. ЧазоваРоссияNational Medical Research Center of Cardiology N. A. academician E.I. ChazovRussian FederationГородская клиническая больница им. И.В. ДавыдовскогоРоссияHospital City Clinical Hospital n. a. I.V. DavydovskyRussian Federation2024141120241543848Copyright © Соболевская М.С., Гвоздева А.Д., Свирида О.Н., Филатова А.Ю., 20242024Соболевская М.С., Гвоздева А.Д., Свирида О.Н., Филатова А.Ю.Sobolevskaya M.S., Gvozdeva A.D., Svirida O.N., Filatova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1985

Сердечная недостаточность с сохранённой фракцией выброса (СНсФВ) является наиболее распространённой формой сердечной недостаточности (СН) во всём мире и характеризуется тяжёлым течением, неблагоприятным прогнозом, а также ограниченностью эффективных методов лечения. На сегодняшний день отсутствуют надежные прогностические алгоритмы, позволяющие выявлять больных высокого риска, а прогностическая значимость определена лишь для общепринятых клинических и стандартных эхокардиографических показателей в покое. Обнаружение независимых предикторов неблагоприятного прогноза/тяжёлого течения СНсФВ имеет важное значение для определения индивидуальной тактики лечения таких пациентов. В статье изложен обзор зарубежных и отечественных исследований, посвящённых определению клинических, биохимических и гемодинамических предикторов неблагоприятного прогноза и течения СНсФВ. Показано значение оценки этих предикторов для определения прогноза и выбора оптимального лечения пациентов с СНсФВ. Определены направления дальнейших исследований на выделение фенотипов СНсФВ и разработку персонализированной терапии, а также на построение прогностических моделей, позволяющих выявлять пациентов с высоким риском, которым требуется более тщательное наблюдение и/или более интенсивное медикаментозное лечение.

Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure (HF) worldwide and is characterized by a severe course, poor prognosis, and limited effective treatments. To date, there are no reliable prognostic algorithms to identify high-risk patients, and prognostic significance has been determined only for generally accepted clinical and standard resting echocardiographic parameters. The discovery of independent predictors of poor prognosis/severe course of HFpEF is important for determining individual treatment tactics for such patients.The article provides a review of studies devoted to determining clinical, biochemical and hemodynamic predictors of unfavorable progression and prognosis of heart failure with preserved ejection fraction (HFpEF). Significance of assessing of these predictors for determining prognosis and choosing optimal treatment for patients with HFpEF is shown. Directions for further research were identified: identifying phenotypes of HFpEF, developing personalized therapy, construction of prognostic models to identify high-risk patients who require more careful monitoring and/or more intensive drug treatment.

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