medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-6-14-19medsovet-2970Research ArticleКАРДИОЛОГИЯCARDIOLOGYСердечная недостаточность. Современное состояние проблемы: достижения, разочарования, надежды и перспективыHeart failure. The current state of the problem: achievements, frustrations, hopes and prospectsПавлышЕ. Ф.PavlyshE. F.

Павлыш Елена Федоровна – кандидат медицинских наук, заведующий лабораторией эхокардиографии и функциональной визуализации сердечнососудистой системы отделения функциональной диагностики, доцент кафедры терапии и интегративной медицины Института дополнительного профессионального образования

194044, г. Санкт-Петербург, ул. Академика Лебедева, д. 4/2

Pavlysh Elena Fyodorovna – Cand. of Sci. (Med.), Head of the Laboratory of Echocardiography and Functional Visualization of the Cardiovascular System at the Department of Functional Diagnostics, Associate Professor of the Department of Therapy and Integrative Medicine at the Institute of Additional Professional Education of the Federal State Budget Institution «A.M. Nikiforov AllRussian Center of Emergency and Radiation Medicine» Ministry of Emergency Situations of Russia

Saint-Petersburg 

elena.pavlysh@mail.ruХирмановВ. Н.KhirmanovV. N.

Хирманов Владимир Николаевич – доктор медицинских наук, профессор, заведующий отделом сердечно-сосудистой патологии

194044, г. Санкт-Петербург, ул. Академика Лебедева, д. 4/2

Khirmanov Vladimir Nikolaevich – Dr. of Sci. (Med), Professor, Head of the Cardiovascular Pathology Department of the Federal State Budgetary Institution «A.M. Nikiforov AllRussian Center of Emergency and Radiation Medicine» Ministry of Emergency Situations of Russia

 Saint-Petersburg

vkhirmanov@mail.ruПавлышА. В.PavlyshA. V.

Павлыш Андрей Владиславович – доктор медицинских наук, заведующий кафедрой фармакологии и фармации

191015, г. СанктПетербург, ул. Кирочная, д. 41

Pavlysh Andrey Vladislavovich – Dr. of Sci. (Med), Head of the Pharmacology and Pharmacy Department

191015, Saint-Petersburg, 41 Kirochnaya St.

pavlysh_63@mail.ruФедеральное государственное бюджетное учреждение «Всероссийский центр экстренной и радиационной медицины им. А.М. Никифорова» МЧС РоссииРоссияThe Federal State Budgetary Institute «The Nikiforov Russian Center of Emergency and Radiation Medicine» The Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural DisastersRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I.I. Mechnikov» of the Ministry of Health of the Russian FederationRussian Federation201925042019061419Copyright © Павлыш Е.Ф., Хирманов В.Н., Павлыш А.В., 20192019Павлыш Е.Ф., Хирманов В.Н., Павлыш А.В.Pavlysh E.F., Khirmanov V.N., Pavlysh A.V.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/2970

В статье представлены обзорные и статистические данные о сердечной недостаточности и сердечно-сосудистых заболеваниях в России, данные мировых исследований о разных формах сердечной недостаточности в соответствии с современной классификацией, об их клинических, анамнестических и прогностических различиях, о разных подходах к лечению сердечной недостаточности, обсуждены перспективы данного направления кардиологии, в том числе актуальность с точки зрения оценки технологий здравоохранения.

The article presents overview and statistical data on heart failure and cardiovascular diseases in Russia, world research data on various forms of heart failure in accordance with the modern classification, their clinical, anamnestic and prognostic differences, different approaches to the treatment of heart failure , discussion the prospects of this direction in cardiology, including the relevance of medical technology assessment.

сердечная недостаточностьсохраненная фракция выбросасниженная фракция выбросалечение сердечной недостаточностиоценка технологий здравоохраненияheart failurepreserved ejection fractionreduced ejection fractiontreatment of heart failurehealth technology assessmentReferencesФомин И.В. Хроническая сердечная недостаточность в Российской Федерации: что сегодня мы знаем и что должны делать. Российский кардиологический журнал. 2016;8(136):7–13.Fomin I.V. Chronic Heart Failure in the Russian Federation: What We Know Today and What We Should Do. Russian Cardiology Journal [Rossijskij kardiologicheskij zhurnal]. 2016;8(136):7–13. (In Russ.)Фомин И.В., Беленков Ю.Н., Мареев В.Ю. и др. Распространенность хронической сердечной недостаточности в европейской части Российской Федерации (часть 1) – данные ЭПОХА-ХСН. Сердечная недостаточность. 2006;7,1(35):4-7.Fomin I.V., Belenkov Yu.N., Mareev V.Yu., et al. The prevalence of chronic heart failure in the European part of the Russian Federation (part 1) – EHPOHA-HSN. Serdechnaya nedostatochnost. 2006;7,1(35):4-7. (In Russ.)Фомин И.В., Беленков Ю.Н., Мареев В.Ю. и др. Распространенность хронической сердечной недостаточности в европейской части Российской Федерации (часть 2) – данные ЭПОХАХСН. Сердечная недостаточность. 2006;7,3(37): 112-5.Fomin I.V., Belenkov Yu.N., Mareev V.Yu., et al. The prevalence of chronic heart failure in the European part of the Russian Federation (part 2) – EHPOHA-HSN. Serdechnaya nedostatochnost. 2006;7,3(37):112-5. (In Russ.)Напалков Д.А., Сулимов В.А., Сеидов Н.М. Хроническая сердечная недостаточность: смещение фокуса на начальные стадии заболевания. Лечащий врач. 2008;4:14–18.Napalkov D.A., Sulimov V.A., Seidov N.M. Chronic heart failure: shift of focus on the initial stages of the disease. Attending physician [Lechashhiĭ vrach]. 2008;4:14–18. (In Russ.)Levy D., Anderson K., Savage D. Echocardiographically detected left ventricular hypertrophy: prevalence and risk factor. The Framingham Heart Study. Ann Intern Med. 1988;108:7–14.Levy D., Anderson K., Savage D. Echocardiographically detected left ventricular hypertrophy: prevalence and risk factor. The Framingham Heart Study. Ann Intern Med. 1988;108:7–14.Owan T.E., Hodge D.O., Herges R.M. Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2006;7:251–259.Owan T.E., Hodge D.O., Herges R.M. Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2006;7:251–259.Bratia R.S., Tu J.V., Lee D.S. Outcome of Heart Fallure with Preserved Ejec- tion Fraction in a Population-Based Study. N Engl J Med. 2006;7:260–269.Bratia R.S., Tu J.V., Lee D.S. Outcome of Heart Fallure with Preserved Ejec- tion Fraction in a Population-Based Study. N Engl J Med. 2006;7:260–269.Yancy C.W., Lopatin M., Stevenson L.W. Clinical presentation, management, and in- hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function. A report from the acute decompensated heart failure national registry (ADHERE) database. Am Coll Cardiol. J. 2006;47:76–84.Yancy C.W., Lopatin M., Stevenson L.W. Clinical presentation, management, and in- hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function. A report from the acute decompensated heart failure national registry (ADHERE) database. Am Coll Cardiol. J. 2006;47:76–84.Шутов А.М., Тармонова Л.Ю. Нарушение функции почек и анемия у больных пожилого возраста с диастолической сердечной недостаточностью. Тер. архив. 2007;12:25–27.Shutov A.M., Tarmonova L.Yu. Kidney dysfunction and anemia in elderly patients with diastolic heart failure. Ther. archive [Ter. arhiv]. 2007;12:25–27. (In Russ.)Fonarow G.C.? Stough W.G., Abraham W.T. For the OPTIMIZE-HF investigators and hospitals. Characteristics, treatments and outcomes of patients with preserved systolic function hospitazed for heart failure. Am Coll Cardiol. J. 2007;50:768–777.Fonarow G.C.? Stough W.G., Abraham W.T. For the OPTIMIZE-HF investigators and hospitals. Characteristics, treatments and outcomes of patients with preserved systolic function hospitazed for heart failure. Am Coll Cardiol. J. 2007;50:768–777.Triboulloy C. et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J. 2008;29:339–347.Triboulloy C. et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J. 2008;29:339–347.Ponikowski P. 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. European Heart Journal. 2016 July 14;37(27):2129–2200.Ponikowski P. 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. European Heart Journal. 2016 July 14;37(27):2129–2200.McMurray J.J.V. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2012;33:1787–1847.McMurray J.J.V. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2012;33:1787–1847.Lyle M.A., and Brozovich F.V. HFpEF, a Disease of the Vasculature: A Closer Look at the Other Half 2018. Mayo Foundation for Medical Education and Research n Mayo Clin Proc. 2018;nn(n):1-10.Lyle M.A., and Brozovich F.V. HFpEF, a Disease of the Vasculature: A Closer Look at the Other Half 2018. Mayo Foundation for Medical Education and Research n Mayo Clin Proc. 2018;nn(n):1-10.Reddy Y.N., Borlaug B.A. Heart failure with preserved ejection fraction. Curr Probl Cardiol. 2016;41(4):145-188.Reddy Y.N., Borlaug B.A. Heart failure with preserved ejection fraction. Curr Probl Cardiol. 2016;41(4):145-188.Gladden J.D., Linke W.A., Redfield M.M. Heart failure with pre- served ejection fraction. Pflugers Arch. 2014;466(6):1037-1053.Gladden J.D., Linke W.A., Redfield M.M. Heart failure with pre- served ejection fraction. Pflugers Arch. 2014;466(6):1037-1053.Redfield M.M. Heart failure with preserved ejection fraction. N Engl J Med. 2016;375(19):1868-1877.Redfield M.M. Heart failure with preserved ejection fraction. N Engl J Med. 2016;375(19):1868-1877.Bakris G.L., Bank A.J., Kass D.A., Neutel J.M., Preston R.A., Oparil S. Advanced glycation end-product cross-link breakers. A novel approach to cardiovascular pathologies related to the aging process. American Journal of Hypertension. 2004;17(12 Pt 2):23S–30S. doi:10.1016/j.amjhyper.2004.08.022. PMID 15607432.Bakris G.L., Bank A.J., Kass D.A., Neutel J.M., Preston R.A., Oparil S. Advanced glycation end-product cross-link breakers. A novel approach to cardiovascular pathologies related to the aging process. American Journal of Hypertension. 2004;17(12 Pt 2):23S–30S. doi:10.1016/j.amjhyper.2004.08.022. PMID 15607432.Little W.C., Zile M.R., Kitzman D.W., Hundley W.G., O’Brien T.X., Degroof R.C. The effect of alagebrium chloride (ALT-711), a novel glucose cross-link breaker, in the treatment of elderly patients with diastolic heart failure. Journal of Cardiac Failure. 2005;11(3):191–195. PMID 15812746.Little W.C., Zile M.R., Kitzman D.W., Hundley W.G., O’Brien T.X., Degroof R.C. The effect of alagebrium chloride (ALT-711), a novel glucose cross-link breaker, in the treatment of elderly patients with diastolic heart failure. Journal of Cardiac Failure. 2005;11(3):191–195. PMID 15812746.Ji Y., Wang T., Zhang X., Li L., Li L., Guo Y., Yang B., Wang Y., Zhu T. Astragalosides increase the cardiac diastolic function and regulate the «Calcium sensing receptor-protein kinase C-protein phosphatase 1» pathway in rats with heart failure. Biomed Pharmacother. 2018 Jul;103:838-843. doi: 10.1016/j.biopha.2018.04.111. Epub 2018 Apr 24.Ji Y., Wang T., Zhang X., Li L., Li L., Guo Y., Yang B., Wang Y., Zhu T. Astragalosides increase the cardiac diastolic function and regulate the «Calcium sensing receptor-protein kinase C-protein phosphatase 1» pathway in rats with heart failure. Biomed Pharmacother. 2018 Jul;103:838-843. doi: 10.1016/j.biopha.2018.04.111. Epub 2018 Apr 24.Здравоохранение в России 2017. Статистический сборник, Росстат. М., 2017.Healthcare in Russia 2017. Statistical collection, Rosstat. М., 2017. (In Russ.)Christopher A.P., Sandor J.K. The Role of Left Atrial Function in Dia- stolic Heart Failure. Circ Cardio-vasc Imaging. 2009;2:6–9.Christopher A.P., Sandor J.K. The Role of Left Atrial Function in Dia- stolic Heart Failure. Circ Cardio-vasc Imaging. 2009;2:6–9.The International Network of Agencies for Health Technology Assessment (INAHTA). 2015. [Electronic resource]. Режим доступа: http://htaglossary.net/health+technology.The International Network of Agencies for Health Technology Assessment (INAHTA). 2015. [Electronic resource]. Access mode: http://htaglossary.net/health+technology.Федеральный закон «Об обращении лекарственных средств» от 12.04.2010 N 61-ФЗ (последняя редакция). Консультант-Плюс. 2019. [Электронный ресурс]. Режим доступа: http://www.consultant.ru/document/cons_doc_LA/Federal Law «On Circulation of Medicines» dated 12.04.2010 N 61-FZ (last edition). Consultant Plus. 2019. [Electronic resource]. Access mode: http://www.consultant.ru/document/cons_doc_LA/. (In Russ.)

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