Роль ингибиторов неприлизина в лечении сердечной недостаточности с сохраненной фракцией выброса

Клиническое и гемодинамическое ухудшение при сердечной недостаточности с сохраненной фракцией выброса (СНсФВ) во многом связано с прогрессией диастолической дисфункции левого желудочка (ЛЖ). Ключевую роль в нормальном поддержании диастолической функции играет высокий уровень активности внутриклеточной сигнальной оси циклический гуанил-монофосфат–протеинкиназа G, активность которой при СНсФВ существенно снижена. Повысить активность этой оси можно путем увеличения биодоступности натрийуретических пептидов (НУП) с помощью блокады фермента нейтральной эндопептидазы (неприлизина), ответственной за разрушение НУП. В обзоре представлены имеющиеся экспериментальные и клинические данные по применению ингибиторов неприлизина при СНсФВ, рассмотрены перспективы этого способа лечения.

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