Ключевые изменения клинических рекомендаций по ведению пациентов с хронической сердечной недостаточностью

Ларина В.Н., Скиба И.К., Щербина Е.С., Лукин А.А. Ключевые изменения клинических рекомендаций по ведению пациентов с хронической сердечной недостаточностью // CardioСоматика. 2025. Т. 16, № 3. С. 240–249. DOI: 10.17816/CS643236 EDN: RSHICA

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Larina VN, Skiba IK, Shcherbina ES, Lukin AA. Key Updates in Clinical Guidelines for the Management of Patients With Chronic Heart Failure. CardioSomatics. 2025;16(3):240–249. DOI: 10.17816/CS643236 EDN: RSHICA

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Аннотация

Хроническая сердечная недостаточность (ХСН) становится всё более актуальной проблемой в контексте глобального старения населения и определённых достижений системы здравоохранения. В статье анализируются ключевые изменения клинических рекомендаций Европейского общества кардиологов и Российского кардиологического общества по ведению пациентов с ХСН, включая обновлённую классификацию и терапевтические подходы. Поиск литературных источников проведён в электронных базах данных Pubmed, Google Scholar, eLibrary.ru. Новая классификация направлена на улучшение профилактики ХСН, а не только на корректный выбор тактики терапии существующего заболевания. Обсуждается роль ингибиторов натрий-глюкозного котранспортёра 2-го типа, ангиотензиновых рецепторов и неприлизина ингибиторов, а также освещается место нового антагониста минералкортикоидных рецепторов — финеренона. Обобщение последних исследований и экспертного опыта обеспечивает специалистов современными знаниями о лечении ХСН. Однако наиболее важный аспект обновлённых рекомендаций — превентивный подход, направленный на предотвращение развития ХСН. Актуальные данные могут быть полезны как для врачей первичного звена, так и для врачей, оказывающих медицинскую помощь в условиях стационара, врачей-исследователей и позволят повысить качество и улучшить результаты лечения пациентов.

Ключевые слова: хроническая сердечная недостаточность, классификация, финеренон, квадротерапия, клинические рекомендации

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Chronic heart failure (CHF) is an increasingly important issue in the context of global population aging and advances in health care. This article analyzes key updates in the clinical guidelines of the European Society of Cardiology and the Russian Society of Cardiology for the management of patients with CHF, including revised classification and therapeutic approaches. A systematic search was conducted in PubMed, Google Scholar, and eLibrary.ru. The new classification emphasizes prevention of CHF rather than solely focusing on therapeutic strategies for established disease. The article discusses the roles of sodium–glucose cotransporter 2 inhibitors, angiotensin receptor–neprilysin inhibitors, and highlights the novel mineralocorticoid receptor antagonist finerenone. A synthesis of recent studies and expert opinions provides clinicians with current evidence-based knowledge on the management of CHF. The most important aspect of the updated recommendations is the preventive approach aimed at reducing CHF incidence. These data may be useful for primary care physicians, hospital-based clinicians, and clinical researchers, contributing to improved quality and outcomes of patient care.

Keywords: heart failure, classification, finerenone, quadruple therapy, clinical guidelines

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Авторы

В.Н. Ларина*¹, И.К. Скиба¹, Е.С. Щербина¹, А.А. Лукин²

¹Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Россия;
²Диагностический клинический центр № 1, Москва, Россия
*larinav@mail.ru

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Vera N. Larina*¹, Ivan K. Skiba¹, Ekaterina S. Shcherbina¹, Andrei A. Lukin²

¹The Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia;
²Diagnostic Clinical Center No. 1, Moscow, Russia
*larinav@mail.ru

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