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Сердечная ресинхронизирующая терапия у больных с хронической сердечной недостаточностью: взгляд терапевта, кардиолога
Сердечная ресинхронизирующая терапия у больных с хронической сердечной недостаточностью: взгляд терапевта, кардиолога
Резник Е.В., Солтис С.Ю., Устюжанин Д.В., Никитин И.Г. Сердечная ресинхронизирующая терапия у больных с хронической сердечной недостаточностью: взгляд терапевта, кардиолога. CardioСоматика. 2019; 10 (3): 13–29. DOI: 10.26442/22217185.2019.3.190572
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Аннотация
В связи с успехами кардиологии и увеличением продолжительности жизни населения распространенность хронической сердечной недостаточности неуклонно растет. Это, в свою очередь, приводит к увеличению абсолютного числа пациентов, у которых недостаточно эффективна оптимально назначенная медикаментозная терапия. В этом случае пациентам с хронической сердечной недостаточностью II–IV функционального класса с выраженной систолической дисфункцией левого желудочка и расширенным комплексом QRS показана сердечная ресинхронизирующая терапия (CРТ). Несмотря на тщательный отбор пациентов для СРТ, почти в 1/3 случаев устройство не приводит к ожидаемому результату. Для увеличения эффективности данного вмешательства процедуру необходимо выполнять строго в соответствии с актуальными клиническими рекомендациями только комплаентным пациентам, находящимся не менее 3 мес на подобранной оптимальной медикаментозной терапии, использовать оптимальные стратегии и режимы стимуляции. Число пациентов с долгосрочным использованием СРТ прогрессивно увеличивается. Все больше пациентов с установленными устройствами попадают в поле зрения врачей-терапевтов и кардиологов поликлиник и стационаров, для которых крайне важно понимать особенности методики и тактики ведения таких пациентов. Этому посвящена данная публикация.
Ключевые слова: хроническая сердечная недостаточность, сердечная ресинхронизирующая терапия, имплантируемый кардиовертер-дефибриллятор, сердечная ресинхронизирующая терапия с функцией дефибриллятора, оптимальная медикаментозная терапия, прогноз, качество жизни, фракция выброса левого желудочка.
Key words: chronic heart failure, cardiac resynchronization therapy, implantable cardioverter-defibrillator, optimal drug therapy, prognosis, quality of life, left ventricular ejection fraction.
Ключевые слова: хроническая сердечная недостаточность, сердечная ресинхронизирующая терапия, имплантируемый кардиовертер-дефибриллятор, сердечная ресинхронизирующая терапия с функцией дефибриллятора, оптимальная медикаментозная терапия, прогноз, качество жизни, фракция выброса левого желудочка.
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Key words: chronic heart failure, cardiac resynchronization therapy, implantable cardioverter-defibrillator, optimal drug therapy, prognosis, quality of life, left ventricular ejection fraction.
Полный текст
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Авторы
Е.В. Резник*1, С.Ю. Солтис1, Д.В. Устюжанин2, И.Г. Никитин1
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия
*elenaresnik@gmail.com
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 National Medical Research Center of Cardiology, Moscow, Russia
*elenaresnik@gmail.com
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия
*elenaresnik@gmail.com
________________________________________________
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 National Medical Research Center of Cardiology, Moscow, Russia
*elenaresnik@gmail.com
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