В настоящее время определена значимость роли воспаления в патофизиологии хронической сердечной недостаточности (ХСН). Достоверно известно, что повышенный уровень циркулирующих провоспалительных цитокинов у пациентов с ишемической ХСН коррелирует с тяжестью и прогнозом заболевания. Моноциты играют ключевую роль в воспалительном каскаде и являются основным источником как про-и противовоспалительных цитокинов. Дисбаланс физиологического воспаления при повреждении и восстановлении миокарда может привести к формированию патологического хронического воспаления. В этой статье обсуждается роль моноцитов и воспаления при ХСН и ее декомпенсации, а также представлено описание видов цитокинов и их участия в воспалении. Кроме того, представлен анализ результатов исследований лекарственных препаратов, направленных на модуляцию иммунной реакции при ХСН.

It was established that in patients with chronic heart failure (CHF), including CHF with reduced ejection fraction, as well as acute decompensated CHF, the level of serum inflammatory markers was increased. Moreover, experimental studies have shown repeatedly that activation of mechanisms of immune response in the myocardium provokes left ventricular remodeling and progression of left ventricular dysfunction. Nonetheless, clinical studies of anti-inflammatory drugs, including those aimed at blockage of cytokines have been neutral or negative with respect to the primary end points of the trials, and in some patients, resulted in worsening CHF or death. This review discusses variants of the types of inflammation in the myocardium, their immune mediators involved in the pathogenesis of CHF and its progression. Mechanisms of the pathogenesis of inflammatory cardiomyopathy leading to HF are discussed. A more precise conclusion about inflammatory phenotype in myocardial tissue, which will identify therapeutic targets in the treatment of CHF is necessary. Additionally, the review presents modern data about tactics for managing patients with acute decompensation of CHF with systolic dysfunction, which includes optimal medication, invasive and device therapy.

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The article considers the theoretical aspects of mass consciousness and its forms, the essential characteristics of mass behavior, as a result of which the definition of this term is formulated and corrected. The authors  analyze the evolution of concepts of mass consciousness in historical retrospect and at the present stage, its features in the conditions of transition to the digital economy. A fresh look at the problem of mass manipulation in a digital society through various mechanisms is given, and the transformation of mass behavior in the 21st century is analyzed by comparison.