Сердечная недостаточность у пациентов с сохраненной фракцией выброса левого желудочка - насосная несостоятельность сердца?
Аннотация
В обзоре проанализированы данные литературы о хронической сердечной недостаточности (ХСН) как клиническом синдроме гипоперфузии органов и систем организма, обусловленном множественными причинами насосной несостоятельности системы кровообращения. Особое внимание уделено диастолической ХСН различного генеза. Обращается особое внимание на то, что интегральным количественным показателем ХСН любого происхождения является индексированный сердечный выброс (СВ), а не фракция выброса левого желудочка (ФВ ЛЖ), систолическая и диастолическая ХСН - относительно условное разделение понятий. Показано, что при ХСН любого происхождения снижен СВ и страдает кислородное и субстратное обеспечение тканей организма. Многообразие причин ХСН с сохраненной ФВ ЛЖ делает невозможным коррекцию гемодинамических нарушений «стандартным набором» препаратов. Нормализация баланса доставки кислорода и субстратов с метаболическим запросом тканей может оказаться ключевым подходом к лечению диастолической ХСН различного происхождения.
Об авторах
А. А. Соколов
ФГБНУ «Томский национальный исследовательский медицинский центр РАН»; «Научно-исследовательский институт кардиологии», Томск
Россия
Россия
Г. И. Марцинкевич
ФГБНУ «Томский национальный исследовательский медицинский центр РАН»; «Научно-исследовательский институт кардиологии», Томск
Россия
Россия
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Рецензия
Для цитирования:
Соколов А.А., Марцинкевич Г.И. Сердечная недостаточность у пациентов с сохраненной фракцией выброса левого желудочка - насосная несостоятельность сердца? Кардиология. 2018;58(6):79-84. https://doi.org/10.18087/cardio.2018.6.10125
For citation:
Sokolov A.A., Martsinkevich G.I. Heart Failure in Patients With Preserved Ejection Fraction -Pumping Heart Failure? Kardiologiia. 2018;58(6):79-84. (In Russ.) https://doi.org/10.18087/cardio.2018.6.10125
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