sechenovSechenov Medical JournalСеченовский вестник2218-73322658-3348Сеченовский Университет10.47093/2218-7332.2022.13.3.4-13sechenov-870Research ArticleINTERNAL MEDICINEВНУТРЕННИЕ БОЛЕЗНИChronic heart failure with preserved ejection fraction: optimal therapy. Literature reviewХроническая сердечная недостаточность с сохраненной фракцией выброса: оптимальная медикаментозная терапия. Обзор литературыhttps://orcid.org/0000-0003-0524-9043КузьменкоА. А.KuzmenkoA. A.

Кузьменко Анастасия Андреевна - студентка Института клинической медицины им. Н.В. Склифосовского.

ул. Трубецкая, д. 8, стр. 2, Москва, 119991

Тел.: +7 (916) 062-40-15

Anastasia A. Kuzmenko - Student, Institute of Clinical Medicine named after N.V. Sklifosovsky, Sechenov First Moscow State Medical University (Sechenov University).

8/2, Trubetskaya str., Moscow, 119991

Tel.: +7 (916) 062-40-15

anasta.kuz.2015@mail.ruhttps://orcid.org/0000-0001-5938-8917СоколоваА. А.SokolovaA. A.

Соколова Анастасия Андреевна - кандидат медицинских наук, доцент кафедры факультетской терапии № 1.

ул. Трубецкая, д. 8, стр. 2, Москва, 119991

Anastasia A. Sokolova - Cand.  of  Sci.  (Medicine), Associate Professor, Department of Faculty Therapy No. 1, Sechenov First Moscow State Medical University (Sechenov University).

8/2, Trubetskaya str., Moscow, 119991

https://orcid.org/0000-0001-6241-2711НапалковД. А.NapalkovD. A.

Напалков Дмитрий Александрович - доктор медицинских наук, профессор кафедры факультетской терапии № 1.

ул. Трубецкая, д. 8, стр. 2, Москва, 119991

Dmitry A. Napalkov - Dr. of Sci. (Medicine), Professor, Department of Faculty Therapy No. 1, Sechenov First Moscow State Medical University (Sechenov University).

8/2, Trubetskaya str., Moscow, 119991

Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202228102022133413Copyright © Kuzmenko A.A., Sokolova A.A., Napalkov D.A., 20222022Кузьменко А.А., Соколова А.А., Напалков Д.А.Kuzmenko A.A., Sokolova A.A., Napalkov D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sechenovmedj.com/jour/article/view/870

The literature review discusses approaches to the treatment of patients with chronic heart failure and preserved ejection fraction (EF>50) – HFpEF. The impact of various groups of drugs on the prognosis and quality of life of patients in this cohort was assessed based on the results of randomized trials, systematic reviews and meta-analyses, clinical recommendations of recent years. To date, only sodium-glucose cotransporter-2 inhibitors unequivocally improve the quality of life and prognosis of patients with HFpEF. Angiotensin receptor – neprilysin inhibitors and mineralocorticoid receptor antagonists are effective in terms of prognosis and quality of life only in patients with HFpEF in combination with resistant hypertension. In patients with sinus rhythm, heart rate > 70 beats/min and concomitant coronary artery disease, a combination of bisoprolol and ivabradine may be considered. Diuretics are recommended for patients with HFpEF when there are signs of congestion and signs of decompensation. Other groups of drugs do not significantly affect the quality of life and prognosis of patients with HFpEF and can be prescribed to such patients only as part of planned therapy for the treatment of other concomitant cardiovascular diseases.

В данном обзоре литературы обсуждаются подходы к лечению пациентов с хронической сердечной недостаточностью и сохраненной фракцией выброса (50% и более) – ХСНсФВ. Влияние различных групп препаратов на прогноз и качество жизни пациентов данной когорты оценивалось исходя из результатов рандомизированных исследований, систематических обзоров и метаанализов, клинических рекомендаций последних лет. На сегодня только ингибиторы натрий-глюкозного котранспортера 2-го типа однозначно улучшают качество жизни и прогноз пациентов с ХСНсФВ. Ангиотензиновых рецепторов и неприлизина ингибитор и антагонисты минералокортикоидных рецепторов эффективны в отношении прогноза и качества жизни только у пациентов с ХСНсФВ в сочетании с резистентной артериальной гипертензией. У ряда пациентов может быть рассмотрено назначение комбинации бисопролола и ивабрадина при синусовом ритме, частоте сердечных сокращений > 70 уд/мин и сопутствующей ишемической болезни сердца. Диуретики рекомендованы больным ХСНсФВ при появлении признаков застоя и наличии признаков декомпенсации. Остальные группы препаратов достоверно не влияют на качество жизни и прогноз пациентов с ХСНсФВ и могут назначаться таким пациентам только в составе плановой терапии для лечения других сопутствующих сердечно-сосудистых заболеваний.

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