Preview

Кардиология

Расширенный поиск

Сердечная недостаточность у пациентов с сохраненной фракцией выброса левого желудочка - насосная несостоятельность сердца?

https://doi.org/10.18087/cardio.2018.6.10125

Полный текст:

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


Г. И. Марцинкевич
ФГБНУ «Томский национальный исследовательский медицинский центр РАН»; «Научно-исследовательский институт кардиологии», Томск
Россия


Список литературы

1. Bhuiyan T., Maurer M. S. Heart failure with preserved ejection fraction: persistent diagnosis, therapeutic enigma. Curr Cardiovasc Risk Rep 2011; 5 (5): 440-449. DOI: 10.1007/s12170-011-0184-2.

2. Luchi R. J., Snow E., Luchi J. M. et al. Left ventricular function in hospitalized geriatric patients. J. Am Geriatr Soc 1982; 30: 700-705.

3. Vasan R. S., Benjamin E.J., Levy D. Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective. J. Am Coll Cardiol 1995; 26: 1565-1574.

4. Paulus W.J., Tschöpe C., Sanderson J. E. et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007; 28 (20): 2539-2550.

5. Cleland J. G., Swedberg K., Follath F. et al. The EuroHeart Failure survey programme - a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J. 2003; 24 (5): 442-463.

6. Cheitlin M. D., Armstrong W. F., Aurigemma G. P. et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J. Am Soc Echocardiogr 2003; 16: 1091-1110.

7. Lalande S., Johnson B. D. Diastolic dysfunction: a link between hypertension and heart failure. Drugs Today (Barc) 2008; 44 (7): 503-513. DOI: 10.1358/dot. 2008.44.7.1221662.

8. Hunt S. A., Abraham W. T., Chin M. H. et al. ACC/AHA. 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society. Circulation 2005; 112 (12): e154-e235.

9. Spencer K. T., Lang R. M. Diastolic heart failure. What primary care physicians need to know. Postgrad Med 1997; 101 (1): 63-73. OI: 10.3810/pgm.1997.01.142

10. Vasan R. S., Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria. Circulation 2000; 101 (17): 2118-2121.

11. Nagueh S. F., Middleton K.J., Kopelen H. A. et al. Doppler tissue imaging: A noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J. Am Coll Cardiol 1997; 30 (6): 1527-1533.

12. Young A. A., Cowan B. R., Thrupp S. F. et al. Left ventricular mass and volume: Fast calculation with guidepoint modeling on MR images. Radiology 2000; 216 (2): 597-602.

13. Hansen J. E., Sue D. Y., Oren A., Wasserman K. Relation of oxygen uptake to work rate in normal men and men with circulatory disorders. Am J. Cardiol 1987; 59: 669-674.

14. Wasserman K., Beaver W. L., Whipp B. J. Gas exchange theory and the lactic acidosis (anaerobic) threshold. Circulation 1990; 81 (suppl): II-14 - II-30.

15. Metra M., Raddino R., Dei Cas L., Visioli O. Assessment of peak oxygen consumption, lactate and ventilatory thresholds and correlation with resting and exercise hemodynamic data in chronic congestive heart failure. Am J. Cardiol 1990; 65: 1127-1123.

16. Smiseth O. A., Thomson C. R. Atrioventricular filling dynamics, diastolic function and dysfunction. Heart Fail Rev 2000; 5: 291-299.

17. Ruskoaho H. Atrial natriuretic peptide: Synthesis, release, and metabolism. Pharmacol Rev 1992; 44 (4): 479-60.

18. Gutierrez C., Blanchard D. G. Diastolic heart failure: challenges of diagnosis and treatment. Am Fam Physician 2004; 69 (11): 2609-2616.

19. Appleton C. P., Galloway J. M., Gonzalez M. S. et al. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease: additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. J. Am Coll Cardiol 1993; 22: 1972-1982.

20. Kenchaiah S., Evans J. C., Levy D. et al. Obesity and the risk of heart failure. N. Engl J. Med 2002; 347: 305-313.

21. Мареев В. Ю., Беленков Ю. Н., Овчинников А. Г., Агеев Ф. Т. Как лечить диастолическую дисфункцию сердца? Consilium medicum 2002; 3: 114-117

22. Gash A. K., Carabello B. A., Cepin D., Spann J. F. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation 1983; 67: 148-154.

23. Shikano M., Nakatani S., Kim J. et al. Impaired left ventricular systolic function in mitral stenosis. J. Cardiol 2003; 42 (2): 75-79.

24. König K., Guy K.J., Walsh G. et al. Association of BNP, NTproBNP, and early postnatal pulmonary hypertension in very preterm infants. J. Perinatol. 2014 Apr; 34 (4): 296-300. DOI: 10.1038/jp.2014.2. Epub 2014 Feb 6.

25. Perugu S., Rehan V. K., Chow S. L., Baylen B. Plasma biomarkers and echocardiographic indices of left ventricular function in very low birth weight infants. J. Neonatal Perinatal Med 2014; 7 (3): 213-222. DOI: 10.3233/NPM-14814010.

26. Abualsaud A. O., Lowe B. S., Guo K. et al. Cardiac output as a predictor in congenital heart disease: Are we stating the obvious? Int J. Cardiol. 2016 May 1; 210: 143-8. DOI: 10.1016/j.ijcard.2016.02.071. Epub 2016 Feb 8.

27. Williams S. G., Ng L. L., O'Brien R. J. et al. Is plasma N-BNP a good indicator of the functional reserve of failing hearts? The FRESHBNP study. Eur J. Heart Fail 2004 Dec; 6 (7): 891-900.

28. Kitzman D. W., Little W. C., Brubaker P. H. et al. Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA 2002; 288: 2144-2150.

29. Sargent C., Scroop G. C., Nemeth P. M. et al. Maximal oxygen uptake and lactate metabolism are normal in chronic fatigue syndrome. Med Sci Sports Exerc 2002; 34 (1): 51-56.

30. Whipp B.J., Ward S. A., Wasserman K. Respiratory markers of the anaerobic threshold. Adv Cardiol 1986; 35: 47-64.

31. Kim H. L., Kim Y. N., Lee S. K. et al. The impact of acute bout of exercise on circulating cardiac natriuretic peptide and left ventricular function in untrained healthy young subjects. J. Sports Med Phys Fitness 2016 Dec; 56 (12): 1574-1582. Epub 2016 Jan 19.

32. Smart N. A., Steele M. Systematic review of the effect of aerobic and resistance exercise training on systemic brain natriuretic peptide (BNP) and N-terminal BNP expression in heart failure patients. Int J. Cardiol 2010; 140 (3): 260-265. DOI: 10.1016/j.ijcard.2009.07.004.

33. Zile M. R., Kjellstrom B., Bennett T. et al. Effects of exercise on left ventricular systolic and diastolic properties in patients with heart failure and a preserved ejection fraction versus heart failure and a reduced ejection fraction. Circ Heart Fail 2013; 6: 508-516.

34. Borlaug B. A., Melenovsky V., Russell S. D. et al. Impaired chronotropic and vasodilator reserves limit exercise capacity in patients with heart failure and a preserved ejection fraction. Circulation 2006; 114: 2138-2147.

35. Penicka M., Bartunek J., Trakalova H. et al. Heart failure with preserved ejection fraction in outpatients with unexplained dyspnea: a pressure-volume loop analysis. J. Am Coll Cardiol 2010; 55: 1701-1710.

36. Zhongheng Zhang, Hongying Ni, Baolong Lu, Xiao Xu. Changes in brain natriuretic peptide are correlated with changes in global end-diastolic volume index. J. Thorac Dis 2013; 5 (2): 156-160.

37. Seegers J., Zabel M., Grüter T. et al. Natriuretic peptides for the detection ofparoxysmal atrial fibrillation. Open Heart 2015; 2 (1): e000182. DOI: 10.1136/openhrt-2014-000182. eCollection 2015.

38. Wozakowska-Kaplon B., Bartkowiak R., Grabowska U., Janiszewska G. B-type natriuretic peptide level after sinus rhythm restoration in patients with persistent atrial fibrillation - clinical significance. Kardiol Pol 2010; 68 (7): 781-786.

39. Akashi Y.J., Koike A., Omiya K. et al. Relationship between exercise capacity and brain natriuretic peptide in patients after cardiac surgery. Cardiology 2003; 42 (2): 67-74.

40. Fernandes F., Almeida J., Ramires F. et al. NTpro-BNP levels in pericardial diseases and how they are used as complementary evaluation method of diastolic restriction. Inititial experience: 25 cases. Arq Bras Cardiol 2006 Mar; 86 (3): 175-80. Epub 2006 Mar 30

41. Reddy P. R., Dieter R. S., Das P. et al. Utility of BNP in differentiating constrictive pericarditis from restrictive cardiomyopathy in patients with renal insufficiency. J. Card Fail 2007; 13: 668e671.

42. Mady C., Fernandes F., Arteaga E. et al. Serum NT pro-BNP: relation to systolic and diastolic function in cardiomyopathies and peri-cardiopathies. Arq Bras Cardiol 2008; 91: 46e54.

43. Hu K., Ertl G. A new porcine model of hypertensive cardiomyopathy: a helpful tool to explore the HFpEF mystique. Am J. Physiol Heart Circ Physiol 2015; 309 (9): H1390-1. DOI: 10.1152/ajpheart.00713.2015.

44. Nagueh S. F., Mahmarian J. J. Noninvasive cardiac imaging in patients with hypertrophic cardiomyopathy. J. Am Coll Cardiol 2006; 48 (12): 2410-2422. DOI: 10.1016/j. jacc. 2006.07.065

45. Miyaji Y., Iwanaga Y., Nakamura T. et al. Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy. Intern Med 2016; 55 (10): 1261-1268. DOI: 10.2169/internalmedicine.55.6480. Epub 2016 May 15.

46. Wu A. H., Omland T., Wold Knudsen C. et al. Relationship of B-type natriuretic peptide and anemia in patients with and without heart failure: a substudy from the Breathing Not Properly (BNP) Multinational Study. Am J. Hematol 2005; 80 (3): 174-180.

47. Toth M., Vuorinen K. H., Vuolteenaho O. et al. Hypoxia stimulates release of ANP and BNP from perfused rat ventricular myocardium. Am J. Physiol 1994; 266 (4 Pt 2): H1572-1580.

48. Pagé M., Henri C., Pagé P. et al. Brain natriuretic peptide levels and the occurrence of subclinical pulmonary edema in healthy lowland-ers at high altitude. Can J. Cardiol 2015; 31 (8): 1025-1031. DOI: 10.1016/j.cjca.2015.03.024.

49. Woods D., Hooper T., Hodkinson P. et al. Effects of altitude exposure on brain natriuretic peptide in humans. Eur J. Appl Physiol 2011; 111 (11): 2687-2693. DOI: 10.1007/s00421-011-1881-8.

50. Giakoumis A., Berdoukas V., Gotsis E., Aessopos A. Comparison of echocardiographic (US) volumetry with cardiac magnetic resonance (CMR) imaging in transfusion dependent thalassemia major (TM). Cardiovasc Ultrasound 2007; 5: 24.

51. Bart F. Geerts, Leon P. Aarts, Jos R. Jansen. Methods in pharmacology: measurement of cardiac output. Br J. Clin Pharmacol 2011; 71 (3): 316-330. DOI: 10.1111/j.1365-2125.2010.03798.x. PMCID: PMC3045542.

52. Kowalska A., Loboz-Grudzien K., Hirnle T., Sokalski L. Left ventricular diastolic function evaluated by Doppler echocardiography in coronary artery disease in relation to systolic function]. Pol Arch Med Wewn 1999; 102 (4): 855-863

53. Thiel S. W., Kollef M. H., Isakow W. Non-invasive stroke volume measurement and passive leg raising predict volume responsiveness in medical ICU patients: an observational cohort study. Crit Care 2009; 13: R111. DOI: 10.1186/cc7955.

54. Michard F., Alaya S., Zarka V. et al. Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock. Chest 2003; 124: 1900-1908.


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

Просмотров: 73


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)