arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2011-17-4-305-315arthyper-1630Research ArticleОБЗОРREVIEWПрименение биологических маркеров в диагностике диастолической сердечной недостаточностиBiomarkers in diastolic heart failure diagnosingДрапкинаО. М.DrapkinaO. M.drapkina@bk.ruДуболазоваЮ. В.DubolazovaY. V.noemail@neicon.ruПервый московский государственный медицинский университет им. И.М. СеченоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation201128082011174305315Copyright © Драпкина О.М., Дуболазова Ю.В., 20112011Драпкина О.М., Дуболазова Ю.В.Drapkina O.M., Dubolazova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1630

Распространенность диастолической сердечной недостаточности (ДСН) в популяции составляет от 30 до 74 % (в среднем 45 %). Вследствие неспецифических клинических признаков диагностика ее бывает затруднена. В большинстве случаев наличие ДСН может быть подтверждено при эхокардиографическом исследовании. Однако существует необходимость в простом, недорогом тесте, который поможет в диагностике данного вида СН. В настоящее время широко распространено определение натрийуретических пептидов в плазме крови. Кроме того, ведутся поиски новых биомаркеров, способных дать больше информации о прогнозе пациента и эффективности проводимой терапии. Использование наиболее чувствительных и специфичных из них позволит найти индивидуальный подход к ведению каждого больного.

Prevalence of diastolic heart failure (DHF) is 30-74 % (mean 45 %). Вecause of nonspecific clinical symptoms diagnostics is difficult. Presence of DHF can be confirmed by echocardiography. However a simple, cheap test, which could be helpful in diagnostics of DHF, is necessary. Evaluation of plasma natriuretic peptides is common. Nevertheless, search of new biomarkers, which can give more information on prognosis and efficacy of therapy, is going on. Use of the most sensitive and specific biomarkers allow to find individual approach to each patient.

диастолическая сердечная недостаточностьбиомаркерынатрийуретические пептидыdiastolic heart failurebiomarkersnatriuretic peptidesReferencesSmiseth O.A., Tendera M. (Eds.) Diastolic heart failure. - London: Springer-Verlag London Limited, 2008. - 349 p.Smiseth O.A., Tendera M. (Eds.) Diastolic heart failure. - London: Springer-Verlag London Limited, 2008. - 349 p.Mottaram P.M., Marwick T.H. Assessment of diastolic function: what the general cardiologist needs to know // Heart. - 2005. - Vol. 91, № 5. - P. 681-695.Mottaram P.M., Marwick T.H. Assessment of diastolic function: what the general cardiologist needs to know // Heart. - 2005. - Vol. 91, № 5. - P. 681-695.Mark D.B., Felker G.M. B-type natriuretic peptide - a biomarker for all seasons? // N. Engl. J. Med. - 2004. - Vol. 350, № 7. - P. 718-720.Mark D.B., Felker G.M. B-type natriuretic peptide - a biomarker for all seasons? // N. Engl. J. Med. - 2004. - Vol. 350, № 7. - P. 718-720.McCullough P.A., Nowak R.M., McCord J. et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study // Circulation. - 2002. - Vol. 106, № 4. - P. 416-422.McCullough P.A., Nowak R.M., McCord J. et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study // Circulation. - 2002. - Vol. 106, № 4. - P. 416-422.Maisel A.S., McCord J., Nowak R.M. et al. Bedside B-type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction. Results from the Breathing Not Properly Multinational Study // J. Am. Coll. Cardiol. - 2003. - Vol. 41, № 11. - P. 2010-2017.Maisel A.S., McCord J., Nowak R.M. et al. Bedside B-type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction. Results from the Breathing Not Properly Multinational Study // J. Am. Coll. Cardiol. - 2003. - Vol. 41, № 11. - P. 2010-2017.Dokainish H., Zoghbi W.A., Al-Bakshy F.A., Dhir M., Quinones M.A., Nagueh S.F. Optimal noninvasive assessment of LV filling pressures: a comparison of tissue Doppler echocardiography and BNP in patients with pulmonary artery catheters // Circulation. - 2004. - Vol. 109, № 20. - P. 2432-2439.Dokainish H., Zoghbi W.A., Al-Bakshy F.A., Dhir M., Quinones M.A., Nagueh S.F. Optimal noninvasive assessment of LV filling pressures: a comparison of tissue Doppler echocardiography and BNP in patients with pulmonary artery catheters // Circulation. - 2004. - Vol. 109, № 20. - P. 2432-2439.Yamamoto K., Burnett J.C., Jougasaki M. et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy // Hypertension. - 1996. - Vol. 28, № 6. - P. 988-994.Yamamoto K., Burnett J.C., Jougasaki M. et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy // Hypertension. - 1996. - Vol. 28, № 6. - P. 988-994.Wright S.P., Prickett T.C.R., Doughty R.N., Frampton C., Greg D. Amino-terminal pro-C-type natriuretic peptide in heart failure // Hypertension. - 2004. - Vol. 43, № 1. - P. 94-100.Wright S.P., Prickett T.C.R., Doughty R.N., Frampton C., Greg D. Amino-terminal pro-C-type natriuretic peptide in heart failure // Hypertension. - 2004. - Vol. 43, № 1. - P. 94-100.Luchner A., Hengstenberg C., Löwel H., Riegger G.A., Schunkert H., Holmer S. Effect of compensated renal dysfunction on approved heart failure markers: direct comparison of brain natriuretic peptide (BNP) and N-terminal pro-BNP // Hypertension. - 2005. - Vol. 46, № 1. - P. 118-123.Luchner A., Hengstenberg C., Löwel H., Riegger G.A., Schunkert H., Holmer S. Effect of compensated renal dysfunction on approved heart failure markers: direct comparison of brain natriuretic peptide (BNP) and N-terminal pro-BNP // Hypertension. - 2005. - Vol. 46, № 1. - P. 118-123.Wang T.J., Larson M.G., Levy D., Benjamin E.J. et al. Impact of obesity on plasma natriuretic peptide levels // Circulation. - 2004. - Vol. 109, № 5. - P. 594-600.Wang T.J., Larson M.G., Levy D., Benjamin E.J. et al. Impact of obesity on plasma natriuretic peptide levels // Circulation. - 2004. - Vol. 109, № 5. - P. 594-600.Das S.R., Drazner M.H., Dries D.L. et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study // Circulation. - 2005. - Vol. 112, № 4. - P. 2163-2168.Das S.R., Drazner M.H., Dries D.L. et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study // Circulation. - 2005. - Vol. 112, № 4. - P. 2163-2168.Bibbins-Domingo K., Ansari M., Schiller N.B., Massie B., Whooley M.A. B-type natriuretic peptide and ischemia in patients with stable coronary disease: data from the Heart and Soul study // Circulation. - 2003. - Vol. 108, № 24. - P. 2987-2992.Bibbins-Domingo K., Ansari M., Schiller N.B., Massie B., Whooley M.A. B-type natriuretic peptide and ischemia in patients with stable coronary disease: data from the Heart and Soul study // Circulation. - 2003. - Vol. 108, № 24. - P. 2987-2992.Lubien E., DeMaria A., Krishnaswamy K. Utility of B-natriuretic peptide in diagnosing diastolic dysfunction // Circulation. - 2002. - Vol. 105, № 5. - P. 595-601.Lubien E., DeMaria A., Krishnaswamy K. Utility of B-natriuretic peptide in diagnosing diastolic dysfunction // Circulation. - 2002. - Vol. 105, № 5. - P. 595-601.Senni M., Tribouilloy C.M., Rodeheffer R.J. et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991 // Circulation. - 1998. - Vol. 98, № 21. - P. 2282-2289.Senni M., Tribouilloy C.M., Rodeheffer R.J. et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991 // Circulation. - 1998. - Vol. 98, № 21. - P. 2282-2289.Lukowicz T.V., Fischer M., Hense H.W. et al. BNP as a marker of diastolic dysfunction in the general population: Importance of left ventricular hypertrophy // Eur. J. Heart Fail. - 2005. - Vol. 7, № 4. - P. 525-531.Lukowicz T.V., Fischer M., Hense H.W. et al. BNP as a marker of diastolic dysfunction in the general population: Importance of left ventricular hypertrophy // Eur. J. Heart Fail. - 2005. - Vol. 7, № 4. - P. 525-531.Tschope C., Kasner M., Westermann D. et al. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements // Eur. Heart J. - 2005. - Vol. 26, № 21. - P. 2277-2284.Tschope C., Kasner M., Westermann D. et al. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements // Eur. Heart J. - 2005. - Vol. 26, № 21. - P. 2277-2284.Yamaguchi H., Yoshida J., Yamamoto K. et al. Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy // J. Am. Coll. Cardiol. - 2004. - Vol. 43, № 1. - P. 55-60.Yamaguchi H., Yoshida J., Yamamoto K. et al. Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy // J. Am. Coll. Cardiol. - 2004. - Vol. 43, № 1. - P. 55-60.Rousseau M.F., Gurne O., Duprez D. et al. Beneficial neurohormonal profile of spironolactone in severe congestive heart failure: results from the RALES neurohormonal substudy // J. Am. Coll. Cardiol. - 2002. - Vol. 40, № 9. - P. 1596-1601.Rousseau M.F., Gurne O., Duprez D. et al. Beneficial neurohormonal profile of spironolactone in severe congestive heart failure: results from the RALES neurohormonal substudy // J. Am. Coll. Cardiol. - 2002. - Vol. 40, № 9. - P. 1596-1601.Latini R., Masson S., Anand I. et al. Valsartan Heart Failure Trial Investigators. Effects of valsartan on circulating brain natriuretic peptide and norepinephrine in symptomatic chronic heart failure: the Valsartan Heart Failure Trial (Val-HeFT) // Circulation. - 2002. - Vol. 106, № 19. - P. 2454-2458.Latini R., Masson S., Anand I. et al. Valsartan Heart Failure Trial Investigators. Effects of valsartan on circulating brain natriuretic peptide and norepinephrine in symptomatic chronic heart failure: the Valsartan Heart Failure Trial (Val-HeFT) // Circulation. - 2002. - Vol. 106, № 19. - P. 2454-2458.ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 // Eur. Heart J. - 2008. - Vol. 29, № 19. - P. 2388-2442.ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 // Eur. Heart J. - 2008. - Vol. 29, № 19. - P. 2388-2442.Национальные клинические рекомендации // Сб. под ред. Р.Г. Оганова. - 2-е изд. - М.: Изд-во «Силицея-Полиграф», 2009. - 528 с.Национальные клинические рекомендации // Сб. под ред. Р.Г. Оганова. - 2-е изд. - М.: Изд-во «Силицея-Полиграф», 2009. - 528 с.Lok D.J., Van Der Meer P., de la Porte P.W. et al. Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: data from the DEAL-HF study // Clin. Res. Cardiol. - 2010. - Vol. 99, № 5. - P. 323-328.Lok D.J., Van Der Meer P., de la Porte P.W. et al. Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: data from the DEAL-HF study // Clin. Res. Cardiol. - 2010. - Vol. 99, № 5. - P. 323-328.Felker G.M., Fiuzat M., Shaw L.K. et al. Prognostic value of galectin-3 in chronic heart failure: results from the HF-ACTION study // Eur. Heart J. - 2010. - Vol. 31, № 1. - P. 429.Felker G.M., Fiuzat M., Shaw L.K. et al. Prognostic value of galectin-3 in chronic heart failure: results from the HF-ACTION study // Eur. Heart J. - 2010. - Vol. 31, № 1. - P. 429.Jaarsma T., van der Wal M.H., Leesman-Leegte I. et al. Effect of moderate or intensive disease management program on outcome in patients with heart failure // Arch. Intern. Med. - 2008. - Vol. 168, № 3. - P. 316-324.Jaarsma T., van der Wal M.H., Leesman-Leegte I. et al. Effect of moderate or intensive disease management program on outcome in patients with heart failure // Arch. Intern. Med. - 2008. - Vol. 168, № 3. - P. 316-324.Lin Y.H., Lin L.Y., Wu Y.W. et al. The relationship between serum galectin-3 and serum markers of cardiac extracellular matrix turnover in heart failure patients // Clin. Chim. Acta. - 2009. - Vol. 409, № 1-2. - P. 96-99.Lin Y.H., Lin L.Y., Wu Y.W. et al. The relationship between serum galectin-3 and serum markers of cardiac extracellular matrix turnover in heart failure patients // Clin. Chim. Acta. - 2009. - Vol. 409, № 1-2. - P. 96-99.

The authors declare that there are no conflicts of interest present.