Structure and function features and adverse prognostic factors of compensated hypertensive heart disease

Овчинников, А Г; Ozhereljeva, M. V.; Масенко, В. П.; Агеев, Ф Т

doi:10.18087/rhj.2017.3.2347

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…), которые также способны вносить свой «вклад» в развитие СН. Более того, как показали наши собственные исследования, именно сопутствующие заболевания (АГ с гипертрофией ЛЖ в первую очередь) чаще всего (в 72 % случаев) приводят к развитию СН с сохранной ФВ и гораздо реже к развитию ишемического фенотипа СН (всего в 8 % случаев) [17]. Тем не менее у больных с СН и промежуточной ФВ (как и у больных с низкой ФВ) дальнейшее прогрессирование СН, вероятность госпитализации и смерти, а также реакцию на терапию прежде всего предопределяет именно преобладающий фенотип ИБС.…”

Section: клинический фенотипunclassified

Heart failure with mid-range ejection fraction: are there clinical reasons in introduction of this new group as a distinct entity?

Агеев

Овчинников

2018

Kardiologiia

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The article discusses the clinical expedience of isolating into a separate classification subgroup of patients with heart failure and a mid‑range ejection fraction (EF) of 40–49 %. Analysis of studies 2017–2018 focusing on the issue of patients with mid‑range LV EF showed that this subgroup is highly heterogenous and by some clinical and demographic parameters takes an intermediate position between heart failure (HF) patients with reduced (<40 %) and preserved (>50 %) LV EF. However, patients with mid‑range LV EF positively respond to beta‑blocker and RAAS inhibitor therapy, and their response is close to that of patients with reduced LV EF. This is a principal difference between patients with mid‑range and preserved LV EF who generally do not display any beneficial effect of such therapy. One of the major causes for such difference is a dissimilarity of HF etiology and, hence, pathogenesis in patients with reduced and mid‑range LV EF: primarily IHD (so‑called “ischemic” phenotype) in patients with reduced and mid‑range LV EF and non‑cardiac causes (“non‑ischemic” phenotype) in patients with preserved LV EF. Since the nonischemic phenotype is also rather common among patients with mid‑range LV EF a new HF classification should definitely indicate, in addition to LV EF, the clinical phenotype of disease, which is particularly important for patients with mid‑range LV EF of 40–49 %. Further studies should focus on variants of HF clinical phenotypes.

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Section: клинический фенотипunclassified

Heart failure with mid-range ejection fraction: are there clinical reasons in introduction of this new group as a distinct entity?

Агеев

Овчинников

2018

Kardiologiia

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Potential of valsartan+sacubitril therapy in hypertensive heart disease

et al. 2021

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The course of hypertension is often complicated by left ventricular hypertrophy (or hypertensive heart disease, HHD). The main “corridor” of natural HHD is development of heart failure with preserved ejection fraction (HFpEF). With HFpEF, the bioavailability of natriuretic peptides (NP) is significantly reduced, as a result of which the activity of cGMP-PKG signaling pathway, which plays a key role in maintaining normal diastolic function, weakens. It is possible to increase the activity of this pathway using the neprilysin inhibitor sacubitril. In case of HFpEF, the greatest efficacy from valsartan+sacubitril therapy should be expected in patients with severe concentric LVH, who have the most pronounced natriuretic peptide deficiency. Valsartan+sacubitril therapy has a clear hypotensive effect, causes a reversal of left ventricular hypertrophy and fibrosis. Since no effective treatment has yet been found for HFpEF, the main way for HHD treatment should be to prevent the diastolic dysfunction progression, which justifies valsartan+sacubitril therapy starting from the early/ asymptomatic stages.

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The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society

et al. 2021

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Structure and function features and adverse prognostic factors of compensated hypertensive heart disease

Cited by 4 publications

References 25 publications

Heart failure with mid-range ejection fraction: are there clinical reasons in introduction of this new group as a distinct entity?

Heart failure with mid-range ejection fraction: are there clinical reasons in introduction of this new group as a distinct entity?

Potential of valsartan+sacubitril therapy in hypertensive heart disease

The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society

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