References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2015-4-46-51

medsovet-152

Research Article

КАРДИОЛОГИЯ

CARDIOLOGY

По следам последних клинических рекомендаций. Антагонисты минералокортикоидных рецепторов

In the wake of the latest clinical guidelines - mineralocorticoid receptor antagonists in the treatment of chronic heart failure

Жиров

И. В.

Zhirov

I. V.

noemail@neicon.ru

Осмоловская

Ю. Ф.

Osmolovskaya

Y. F.

noemail@neicon.ru

Терещенко

С. Н.

Tereschenko

S. N.

noemail@neicon.ru

НИИ кардиологии им. А.Л. Мясникова, Российский кардиологический научно-производственный комплекс Минздрава России, МоскваРоссияthe Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Russia’s Ministry of HealthRussian Federation

2015

30122015

044651

2015

Жиров И.В., Осмоловская Ю.Ф., Терещенко С.Н.

Zhirov I.V., Osmolovskaya Y.F., Tereschenko S.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.med-sovet.pro/jour/article/view/152

Хроническая сердечная недостаточность (ХСН) остается одним из наиболее прогностически неблагоприятных состояний в современной кардиологии. За последние 10-15 лет в дополнение к несомненным доказательствам эффективности ингибиторов ангиотензинпревращающего фермента (ИАПФ), блокаторов рецепторов к ангиотензину (БРА), бета-адреноблокаторов (БАБ) были получены результаты применения новых фармакологических препаратов (антагонисты рецепторов минералокортикоид-ных рецепторов (АМКР), ингибиторы активности синусового узла и нефармакологических способов лечения - имплантация кардиовертеров-дефибрилляторов, кардиальная ресинхронизирующая терапия). В последних клинических рекомендациях по диагностике и лечению сердечной недостаточности перечисленные подходы имеют разный класс рекомендаций и уровень доказательности. Одним из наиболее значимых изменений в фармакотерапии ХСН является факт добавления АМКР к ИАПФ и БАБ в качестве основного средства лечения пациентов с систолической сердечной недостаточностью (класс рекомендаций I, уровень доказательности А). Ниже мы хотим сосредоточиться на основных аспектах применения АМКР у данной группы пациентов.

Chronic heart failure (CHF) today is a heart condition with the least favourable prognosis. Over the past 10-15 years, in addition to strong rationale supporting the effectiveness of angiotensin-converting enzyme inhibitors (ACEI), results of use were obtained for angiotensin receptor blockers (ARB) and beta-blockers (BB), as well as new pharmacotherapies, such as mineralocorticoid receptor antagonists (MCRA), sinoatrial node activity inhibitors, and non-pharmacological interventions - implantable cardioverter-defibrillators and cardiac resynchronization therapy. The recent clinical guidelines for diagnosis and treatment of heart failure provide different classes of recommendation and levels of evidence for the mentioned approaches. One of the most significant changes in CHF pharmacotherapy is supplementation of ACEI and BB with MCRA as the primary treatment for patients with systolic heart failure (class I recommendation, A level of evidence). In this article, we would like to focus on the key aspects of using MCRA in patients with CHF.

ингибитор ангиотензинпревращающего ферментахроническая сердечная недостаточностьэплеренонИнспраangiotensin-converting enzyme inhibitorchronic heart failureeplerenone

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