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Кардиология

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Циркулирующий нейрегулин-1 и хроническая сердечная недостаточность с сохранной фракцией выброса

https://doi.org/10.18087/cardio.2020.11.n1222

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Аннотация

Хроническая сердечная недостаточность (ХСН) с сохранной фракцией выброса (ХСНсФВ) представляет нерешенную социальнозначимую проблему, поскольку ассоциируется с высоким уровнем заболеваемости и смертности. Ранние маркеры данной патологии отсутствуют, а подходы к лечению не разработаны. Существует необходимость дальнейшего изучения механизмов развития ХСНсФВ для выявления терапевтических мишеней. Согласно современным представлениям о патогенезе, важная роль в развитии ХСНсФВ отводится системному воспалению и дисфункции эндотелия, которые способствуют формированию фиброза миокарда и нарушению процессов релаксации кардиомиоцитов, приводя к диастолической дисфункции и повышению давления наполнения левого желудочка (ЛЖ). Нейрегулин-1 (NRG-1) – паракринный фактор роста и естественный агонист рецепторов семейства ErbB, синтезируемый эндотелием коронарных микрососудов. NRG-1 / ErbB4 система сердца активируется на ранних стадиях ХСНнФВ, повышая устойчивость кардиомиоцитов к воздействию окислительного стресса. Доклинические и клинические (фазы II и III) исследования показывают, что терапия рекомбинантным NRG-1 приводит к улучшению сократительной способности миокарда, развитию обратного ремоделирования ЛЖ. Результаты последних исследований свидетельствуют о возможных противовоспалительных и антифибротических эффектах NRG-1, что формирует предпосылки для изучения активности данной системы у больных с ХСНсФВ.

 

Об авторах

А. А. Щендрыгина
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия

к.м.н., ассистент, Кафедра госпитальной терапии №1



К. А. Жбанов
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
ассистент, Кафедра госпитальной терапии №1


Е. В. Привалова
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
д.м.н., профессор, Кафедра госпитальной терапии №1


А. О. Юсупова
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., доцент, Кафедра госпитальной терапии №1


А. Х. Бытдаева
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
студенка 6 курса


Ю. А. Данилогорская
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., ассистент, Кафедра госпитальной терапии №1


Е. А. Железных
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., ассистент, Кафедра госпитальной терапии №1


А. Ю. Суворов
ООО "Ферон"
Россия
к.м.н., биостатистик, отдел клинических исследований


В. Ю. Зекцер
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., ассистент, Кафедра госпитальной терапии №1


М. Г. Мнацаканян
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
д.м.н., доцент, Кафедра госпитальной терапии №1, зав. отделением гастроэнтерологии, Университетсткая клининическая больница №1


О. В. Ляпидевская
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
врач УЗИ, Университетсткая клининическая больница №1


Н. В. Хабарова
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., ассистент, Кафедра госпитальной терапии №1


Ю. И. Найманн
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
к.м.н., ассистент, Кафедра госпитальной терапии №1, зав. отделением кардиологии №1


Ю. Н. Беленков
ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет), Москва
Россия
д.м.н., профессор, академик РАН, зав. кафедрой госпитальной терапии №1


Е. С. Старостина
ГБУЗ "ГКБ им. А.К. Ерамишанцева", Москва
Россия
к.м.н., терапевт, Городская клиническая больница им. А.К. Ерамишанцева


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Для цитирования:


Щендрыгина А.А., Жбанов К.А., Привалова Е.В., Юсупова А.О., Бытдаева А.Х., Данилогорская Ю.А., Железных Е.А., Суворов А.Ю., Зекцер В.Ю., Мнацаканян М.Г., Ляпидевская О.В., Хабарова Н.В., Найманн Ю.И., Беленков Ю.Н., Старостина Е.С. Циркулирующий нейрегулин-1 и хроническая сердечная недостаточность с сохранной фракцией выброса. Кардиология. 2020;60(11):128–136. https://doi.org/10.18087/cardio.2020.11.n1222

For citation:


Shchendrigina A.A., Zhbanov K.A., Privalova E.V., Iusupova A.O., Bytdaeva A.H., Danilogorskaya Yu.A., Zheleznykh E.A., Suvorov A.Yu., Zektser V.Yu., Mnatsakanyan M.G., Lyapidevskaya O.V., Khabarova N.V., Naymann Yu.I., Belenkov Yu.N., Starostina E.S. Circulating Neuregulin-1 and Chronic Heart Failure with Preserved Ejection. Kardiologiia. 2020;60(11):128–136. (In Russ.) https://doi.org/10.18087/cardio.2020.11.n1222

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