arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2023-29-2-138-149arthyper-2284Research ArticleСтатьиArticlesГипертензионное сердце: от гипертрофии левого желудочка к хронической сердечной недостаточностиHypertensive heart: from left ventricular hypertrophy to chronic heart failurehttps://orcid.org/0000-0002-3786-9995СеменкинА. А.SemenkinA. A.

Семенкин Александр Анатольевич — доктор медицинских наук, профессор, профессор кафедры внутренних болезней и семейной медицины ДПО ФГБОУ ВО ОмГМУ Минздрава России.

ул. Ленина, д. 12, Омск, 644099

Aleksandr A. Semenkin - MD, PhD, DSc, Professor, Professor of the Department of Internal Medicine and Family Medicine (Postgraduate Course), Omsk State Medical University.

12 Lenin str., Omsk, 644099

asemyonkin@mail.ruhttps://orcid.org/0000-0001-8317-7765ДрукИ. В.DrukI. V.

Друк Инна Викторовна — доктор медицинских наук, доцент, заведующая кафедрой внутренних болезней и семейной медицины ДПО ФГБОУ ВО ОмГМУ Минздрава России.

ул. Ленина, д. 12, Омск, 644099

Inna V. Druk - MD, PhD, DSc, Associate Professor, Head, Department of Internal Medicine and Family Medicine (Postgraduate Course), Omsk State Medical University.

12 Lenin str., Omsk, 644099

drukinna@yandex.ruhttps://orcid.org/0000-0002-3823-7367ПотаповВ. В.PotapovV. V.

Потапов Виктор Владимирович — кандидат медицинских наук, доцент, доцент кафедры внутренних болезней и семейной медицины ДПО ФГБОУ ВО ОмГМУ Минздрава России.

ул. Ленина, д. 12, Омск, 644099

Viktor V. Potapov - MD, PhD, Associate Professor, Associate Professor of the Department of Internal Medicine and Family Medicine (Postgraduate Course), Omsk State Medical University.

12 Lenin str., Omsk, 644099

potapovvv@mail.ruhttps://orcid.org/0000-0002-4462-569XСапроненкоВ. С.SapronenkoV. S.

Сапроненко Владимир Сергеевич — ординатор 1-го года обучения ФГБОУ ВО ОмГМУ Минздрава России.

ул. Ленина, д. 12, Омск, 644099

Vladimir S. Sapronenko - MD, First-Year Resident, Omsk State Medical University.

12 Lenin str., Omsk, 644099

vssapronenko@mail.ruhttps://orcid.org/0009-0006-9527-2608ЗахароваА. В.ZakharovaA. V.

Захарова Арина Валерьевна — ординатор 1-го года обучения ФГБОУ ВО ОмГМУ Минздрава России.

ул. Ленина, д. 12, Омск, 644099

Arina V. Zakharova - MD, First-Year Resident, Omsk State Medical University.

12 Lenin str., Omsk, 644099

av.zakharova@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Омский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияOmsk State Medical UniversityRussian Federation202314052023292138149Copyright © Семенкин А.А., Друк И.В., Потапов В.В., Сапроненко В.С., Захарова А.В., 20232023Семенкин А.А., Друк И.В., Потапов В.В., Сапроненко В.С., Захарова А.В.Semenkin A.A., Druk I.V., Potapov V.V., Sapronenko V.S., Zakharova A.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/2284

Целью данного обзора является освещение патофизиологических механизмов последовательного формирования гипертрофии левого желудочка (ГЛЖ), дисфункции левого желудочка и хронической сердечной недостаточности (ХСН) у пациентов с артериальной гипертензией (АГ), особенностей диагностики и лечения ХСН как со сниженной, так и с сохраненной фракцией выброса (ФВ). АГ относится к основным факторам риска сердечно-сосудистых заболеваний и сопровождается поражением органов-мишеней, среди которых особое значение имеет ГЛЖ. С одной стороны, формирование ГЛЖ является следствием увеличенной нагрузки на сердечную мышцу и нейрогуморальных стимулов, а с другой — независимым фактором риска инфаркта миокарда, мозгового инсульта, аритмий и ХСН. Согласно данным Фремингемского исследования, АГ предшествует вновь развившейся сердечной недостаточности у 91 % пациентов с преобладанием ХСН с сохраненной ФВ. На сегодняшний день доказана возможность различных групп препаратов улучшать прогноз пациентов с АГ, ХСН со сниженной ФВ, вызывать регресс ГЛЖ. Однако возможности эффективного лечения пациентов с ХСН с сохраненной ФВ все еще остаются недостаточно изученными.

Objective. The purpose of this review is to highlight the pathophysiological mechanisms of the sequential formation of left ventricular hypertrophy (LVH), left ventricular dysfunction and chronic heart failure (CHF) in patients with hypertension (HTN), diagnostic and therapeutical issues of CHF with both reduced and preserved ejection fraction (EF). HTN is the main risk factor for cardiovascular diseases and is accompanied by damage of target organs, among which LVH is of particular importance. On the one hand, development of LVH is the consequence of increased load on the heart muscle and neurohumoral stimuli, and on the other hand, it is an independent risk factor for myocardial infarction, stroke, cardiac arrhythmias and CHF. HTN precedes newly developed heart failure in 91 % of patients with a predominance of CHF with a preserved EF according to the Framingham Heart Study. To date, different drugs can improve the prognosis of patients with HTN, CHF with reduced EF and to induce LVH regression. However, the issues of effective treatment of patients with CHF with preserved EF are still insufficiently studied.

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