arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2025-2514GOLMOFarthyper-2514Research ArticleСтатьиArticlesАртериальная гипертензия и хроническая сердечная недостаточность с сохраненной фракцией выброса (обзор литературы)Arterial hypertension and chronic heart failure with preserved ejection fraction (literature review)https://orcid.org/0000-0002-3620-0659ГапонЛ. И.GaponL. I.

Гапон Людмила Ивановна - доктор медицинских наук, профессор, заслуженный деятель науки РФ, научный  руководитель отделения артериальной гипертонии и коронарной недостаточности,

ул. Мельникайте, д. 111, Тюмень, 625026

Lyudmila I. Gapon, MD, PhD, DSc, Professor, Honored Scientist of the Russian Federation, Head, Arterial Hypertension and Coronary Heart Disease Department, 

111 Melnikaite street, Tyumen, 625026 

gapon@infarkta.nethttps://orcid.org/0000-0002-5479-0859СамойловаЕ. П.SamoilovaE. P.

Елена Петровна Самойлова - кандидат медицинских наук, научный сотрудник отделения артериальной гипертониии коронарной недостаточности,

ул. Мельникайте, д. 111, Тюмень, 625026

Elena P Samoilova, MD, PhD, Research Scientist, Arterial Hypertension and Coronary Heart Disease Department,

111 Melnikaite street, Tyumen, 625026 

samoilova@infarkta.netТюменский кардиологический научный центр — филиал Федерального государственного бюджетного научного учреждения «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияTyumen Cardiology Research Center, Tomsk National Medical Research CenterRussian Federation202502032026316483496Copyright © Гапон Л.И., Самойлова Е.П., 20262026Гапон Л.И., Самойлова Е.П.Gapon L.I., Samoilova E.P.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/2514

В обзоре представлены данные литературы о роли артериальной гипертензии в формировании сердечной недостаточности с сохраненной фракцией выброса (ХСНсФВ). Рассматриваются патогенетические механизмы становления ХСНсФВ с акцентом на гипертрофию миокарда левого желудочка, вопросы диагностики, включая использование метода speckle tracking эхокардиографии, позволяющего представить глобальную и регионарную функцию миокарда на основе оценки деформации левого предсердия. Особенное внимание уделяется предстадии ХСН, ее диагностике, роли левого предсердия, значению показателя деформации левого предсердия. Раннее выявление предстадии ХСН имеет не только клиническое, но и прогностическое значение и требует усиления профилактических мероприятий, призванных замедлить движение от предстадии ХСН до ХСНсФВ.

The review presents literature data on the role of arterial hypertension in the development of heart failure with preserved ejection fraction (HFpEF) and considers the underlying pathogenetic mechanisms with the focus on left ventricular hypertrophy. It also discusses diagnostic issues, including the use of speckle tracking echocardiography for evaluating global and regional myocardial function based on analysis of left atrial deformation. Special attention is given to the pre-stage of HF and its diagnosis, as well as the role of left atrial function and left atrial deformation index. The early detection of HF pre-stage has both clinical and prognostic significance, and requires intensive preventive measures to slow the progression from HF pre-stage to HFpEF.

сердечная недостаточность с сохраненной фракцией выбросаартериальная гипертензиядеформация левого предсердияпредстадия сердечной недостаточностиheart failure with preserved ejection fractionarterial hypertensionleft atrial deformationprestage of heart failureReferencesMcDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol. 2023;81(18):1810–1834. https://doi.org/10.1016/j.jacc.2023.01.049Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol. 2023;81(18):1810–1834. https://doi.org/10.1016/j.jacc.2023.01.049Галявич А.С., Терещенко С.Н., Ускач Т.М., Агеев Ф.Т., Аронов Д.М., Арутюнов Г. П. и др. Хроническая сердечная недостаточность. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(11):6162. https://doi.org/10.15829/1560-4071-2024-6162GalyavichAS, Tereshchenko SN, Uskach TM, Ageev FT, Aronov DM, Arutyunov GP, et al. Clinical practice guidelines for chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6162Kim Mi-Na, Park Seong-Mi. Heart failure with preserved ejection fraction: insights from recent clinical researches. Korean J Intern Med. 2020;35:514–534. https://doi.org/10.3904/kjim.2020.104Kim Mi-Na, Park Seong-Mi. Heart failure with preserved ejection fraction: insights from recent clinical researches. Korean J Intern Med. 2020;35:514–534. https://doi.org/10.3904/kjim.2020.104Jasinska-Piadlo A, Campbell P. Management of patients with heart failure and preserved ejection fraction. Heart. 2023;109(11):874– 883. https://doi.org/10.1136/heartjnl-2022-321097Jasinska-Piadlo A, Campbell P. Management of patients with heart failure and preserved ejection fraction. Heart. 2023;109(11):874– 883. https://doi.org/10.1136/heartjnl-2022-321097Tah S, Valderrama M, Afzal M, Iqbal J, Farooq A, Lak MA, et al. Heart failure with preserved ejection fraction: an evolving understanding. Cureus. 2023;15(9): e46152. https://doi.org/10.7759/cureus.46152Tah S, Valderrama M, Afzal M, Iqbal J, Farooq A, Lak MA, et al. Heart failure with preserved ejection fraction: an evolving understanding. Cureus. 2023;15(9): e46152. https://doi.org/10.7759/cureus.46152Conrad N, Judge A, Tran J. Mohseni H, Hedgecott D, Cre spillo AP, et al. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet. 2018;391(10120):572–580. https://doi.org/10.1016/S0140-6736(17)32520-5Conrad N, Judge A, Tran J. Mohseni H, Hedgecott D, Cre spillo AP, et al. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet. 2018;391(10120):572–580. https://doi.org/10.1016/S0140-6736(17)32520-5Khan MS, Shahid I, Bennis A, Rakisheva A, Metra M, Butler J. Global epidemiology of heart failure. Nat Rev Cardiol. 2024;21(10):717–734. https://doi.org/10.1038/s41569-024-01046-6Khan MS, Shahid I, Bennis A, Rakisheva A, Metra M, Butler J. Global epidemiology of heart failure. Nat Rev Cardiol. 2024;21(10):717–734. https://doi.org/10.1038/s41569-024-01046-6Бойцов С.А., Лукьянов М.М., Якушин С.С., Марцевич С.Ю., Воробьев А. Н., Загребельный А.В. и др. Регистр кардиоваскулярных заболеваний (РЕКВАЗА): диагностика, сочетанная сердечно-сосудистая патология, сопутствующие заболевания и лечение в условиях реальной амбулаторно-поликлинической практики. Кардиоваскулярная терапия и профилактика. 2014;13(6):44–50. https://doi.org/10.15829/1728-8800-2014-6-44-50Boytsov SA, Luk’yanov MM, Yakushin SS, Martsevich SYu, Vorobyov AN, Zagrebelny AV, et al. Cardiovascular disease registry (RECVAZA): diagnostic, concomitant cardiovascular pathology, comorbidities and treatment in the real outpatient-polyclinic practice. Cardiovascular Therapy and Prevention. 2014;13(6):44–50. (In Russ.) https://doi.org/10.15829/1728-8800-2014-6-3-8Шляхто Е.В., Беленков Ю.Н., Бойцов С.А., Виллевальде С.В., Галявич А.С., Глезер М.Г. и др. Результаты промежуточного анализа проспективного наблюдательного многоцентрового регистрового исследования пациентов с хронической сердечной недостаточностью в Российской Федерации «ПРИОРИТЕТ-ХСН»: исходные характеристики и лечение первых включенных пациентов. Российский кардиологический журнал. 2023;28(10):5593. https://doi.org/10.15829/1560-4071-2023-5593Shlyakhto EV, Belenkov YuN, Boytsov SA, Villevalde SV, Galyavich AS, Glezer MG, et al. Interim analysis of a prospective observational multicenter registry study of patients with chronic heart failure in the Russian Federation “PRIORITET-CHF”: initial characteristics and treatment of the first included patients. Russian Journal of Cardiology. 2023;28(10):5593. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5593Grassi G, Drager LF. Sympathetic overactivity, hypertension and cardiovascular disease: state of the art. Curr Med Res Opin. 2024;40(sup1):5–13. https://doi.org/10.1080/03007995.2024.2305248Grassi G, Drager LF. Sympathetic overactivity, hypertension and cardiovascular disease: state of the art. Curr Med Res Opin. 2024;40(sup1):5–13. https://doi.org/10.1080/03007995.2024.2305248Grassi G, Dell’Oro R, Quarti-Trevano F, Vanoli J, Oparil S. Sympathetic neural mechanisms in hypertension: recent insights. Curr Hypertens Rep. 2023;25(10):263–270. https://doi.org/10.1007/s11906-023-01254-4Grassi G, Dell’Oro R, Quarti-Trevano F, Vanoli J, Oparil S. Sympathetic neural mechanisms in hypertension: recent insights. Curr Hypertens Rep. 2023;25(10):263–270. https://doi.org/10.1007/s11906-023-01254-4Pugliese NR, Masi S, Taddei S. The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure. Heart Fail Rev. 2020;25(1):31–42. https://doi.org/10.1007/s10741-019-09855-5Pugliese NR, Masi S, Taddei S. The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure. Heart Fail Rev. 2020;25(1):31–42. https://doi.org/10.1007/s10741-019-09855-5Chang JW, Ramchandra R. The sympathetic nervous system in heart failure with preserved ejection fraction. Heart Fail Rev. 2025;30(1):209–218. https://doi.org/10.1007/s10741-024-10456-0Chang JW, Ramchandra R. The sympathetic nervous system in heart failure with preserved ejection fraction. Heart Fail Rev. 2025;30(1):209–218. https://doi.org/10.1007/s10741-024-10456-0Tsutsui H, Albert N, Coats AJS, Anker SD, Bayes-Genis A, Butler J. Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the heart failure association of the European Society of Cardiology, Heart Failure Society of American and Japanese Heart Failure Society. Eur J Heart Fail. 2023;25(5):616–631. https://doi.org/10.1002/ejhf.2848Tsutsui H, Albert N, Coats AJS, Anker SD, Bayes-Genis A, Butler J. Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the heart failure association of the European Society of Cardiology, Heart Failure Society of American and Japanese Heart Failure Society. Eur J Heart Fail. 2023;25(5):616–631. https://doi.org/10.1002/ejhf.2848Vinnakota S, Chen HH. The Importance of natriuretic peptides in cardiometabolic diseases. J Endocr Soc. 2020;4(6):bvaa052. https://doi.org/10.1210/jendso/bvaa052Vinnakota S, Chen HH. The Importance of natriuretic peptides in cardiometabolic diseases. J Endocr Soc. 2020;4(6):bvaa052. https://doi.org/10.1210/jendso/bvaa052Bayes-Genis A, Morant-Talamante N, Lupon J. Neprilysin and natriuretic peptide regulation in heart failure. Curr Heart Fail Rep. 2016;13:151–157. https://doi.org/10.1007/s11897-016-0292-xBayes-Genis A, Morant-Talamante N, Lupon J. Neprilysin and natriuretic peptide regulation in heart failure. Curr Heart Fail Rep. 2016;13:151–157. https://doi.org/10.1007/s11897-016-0292-xXiao L, Harrison DG. Inflammation in hypertension. Can J Cardiol. 2020;36:635–647. https://doi.org/10.1016/j.cjca.2020.01.013Xiao L, Harrison DG. Inflammation in hypertension. Can J Cardiol. 2020;36:635–647. https://doi.org/10.1016/j.cjca.2020.01.013Zhang Z, Zhao L, Zhou X, Meng X, Zhou X. Role of inflammation, immunity, and oxidative stress in hypertension: new insights and potential therapeutic targets. Front Immunol. 2023;13:1098725. https://doi.org/10.3389/fimmu.2022.1098725Zhang Z, Zhao L, Zhou X, Meng X, Zhou X. Role of inflammation, immunity, and oxidative stress in hypertension: new insights and potential therapeutic targets. Front Immunol. 2023;13:1098725. https://doi.org/10.3389/fimmu.2022.1098725Rizzoni D, De Ciuceis C, Szczepaniak P, Paradis P, Schiffrin EL, Guzik TJ. Immune system and microvascular remodeling in humans. Hypertension. 2022;79(4):691–705. https://doi.org/10.1161/HYPERTENSIONAHA.121.17955Rizzoni D, De Ciuceis C, Szczepaniak P, Paradis P, Schiffrin EL, Guzik TJ. Immune system and microvascular remodeling in humans. Hypertension. 2022;79(4):691–705. https://doi.org/10.1161/HYPERTENSIONAHA.121.17955Adamczak DM., Oduah M-T, Kiebalo T, Nartowicz S, Bęben M, Pochylski M, et al. Heart failure with preserved ejection fraction — a concise review. Current Cardiology Reports. 2020;22(9):82. https://doi.org/10.1007/s11886-020-01349-3Adamczak DM., Oduah M-T, Kiebalo T, Nartowicz S, Bęben M, Pochylski M, et al. Heart failure with preserved ejection fraction — a concise review. Current Cardiology Reports. 2020;22(9):82. https://doi.org/10.1007/s11886-020-01349-3Бузиашвили Ю.И., Асымбекова Э.У., Тугеева Э.Ф., Рахимов А.З., Шахназарян Л.С., Акилджонов Ф.Р. Молекулярные механизмы воспаления при развитии сердечной недостаточности. Consilium Medicum. 2023;25(10):679–684. https://doi.org/10.26442/20751753.2023.10.202433Buziashvili YuI, Asymbekova EU, Tugeeva EF, Rakhimov AZ, Shahnazaryan LS, Akildzhonov FR. Molecular mechanisms of inflammation in the development of heart failure: a review. Consilium Medicum. 2023;25(10):679–684. (In Russ.) https://doi.org/10.26442/20751753.2023.10.202433Leache L, Gutiérrez–Valencia M, Finizola RM, Infante E, Finizola B, Pardo J. Pharmacotherapy for hypertensioninduced left ventricular hypertrophy. Cochrane Database Syst Rev. 2021;10(10):CD012039. https://doi.org/10.1002/14651858.CD012039.pub3Leache L, Gutiérrez–Valencia M, Finizola RM, Infante E, Finizola B, Pardo J. Pharmacotherapy for hypertensioninduced left ventricular hypertrophy. Cochrane Database Syst Rev. 2021;10(10):CD012039. https://doi.org/10.1002/14651858.CD012039.pub3Chun KH, Kang SM. Blood pressure and heart failure: focused on treatment. Clin Hypertens. 2024;30(1):15. https://doi.org/10.1186/s40885-024-00271-yChun KH, Kang SM. Blood pressure and heart failure: focused on treatment. Clin Hypertens. 2024;30(1):15. https://doi.org/10.1186/s40885-024-00271-yLorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102(4):470–479. https://doi.org/10.1161/01.cir.102.4.470Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102(4):470–479. https://doi.org/10.1161/01.cir.102.4.470Takei Y, Tomiyama H, Higashi Y, Yamashina A, Chikamori T. Association between endothelial dysfunction and left ventricular diastolic stiffness-subanalysis of the Flow-Mediated Dilation Japan (FMD-J) study. Circ J. 2023;87(9):1203–1211. https://doi.org/10.1253/circj.CJ-22-0810Takei Y, Tomiyama H, Higashi Y, Yamashina A, Chikamori T. Association between endothelial dysfunction and left ventricular diastolic stiffness-subanalysis of the Flow-Mediated Dilation Japan (FMD-J) study. Circ J. 2023;87(9):1203–1211. https://doi.org/10.1253/circj.CJ-22-0810Budzyń M, Gryszczyńka B, Boruczkowski M, KaczmarekM, Begier-Krasińska B, Osińska A, et al. The potential role of circulating endothelial cells and endothelial progenitor cells in the prediction of left ventricular hypertrophy in hypertensive patients. Front Physiol. 2019;10:1005. https://doi.org/10.3389/fphys.2019.01005Budzyń M, Gryszczyńka B, Boruczkowski M, KaczmarekM, Begier-Krasińska B, Osińska A, et al. The potential role of circulating endothelial cells and endothelial progenitor cells in the prediction of left ventricular hypertrophy in hypertensive patients. Front Physiol. 2019;10:1005. https://doi.org/10.3389/fphys.2019.01005Zan Y, Wang J, Wang W, Scamurra RW, Lin G. Inflammatory cytokines and their correlations with different left ventricular geometries and functions in PHT patients. Echocardiography. 2022;39(12):1589–1600. https://doi.org/10.1111/echo.15495Zan Y, Wang J, Wang W, Scamurra RW, Lin G. Inflammatory cytokines and their correlations with different left ventricular geometries and functions in PHT patients. Echocardiography. 2022;39(12):1589–1600. https://doi.org/10.1111/echo.15495Cui T, Wang J, Shui W, Markman HJ. The relationship of interleukin 6 and C-reactive protein with left ventricular geometry and function in patients with obstructive sleep apnea syndrome and pre-hypertension. Echocardiography. 2022;39(2):286–293. https://doi.org/10.1111/echo.15305Cui T, Wang J, Shui W, Markman HJ. The relationship of interleukin 6 and C-reactive protein with left ventricular geometry and function in patients with obstructive sleep apnea syndrome and pre-hypertension. Echocardiography. 2022;39(2):286–293. https://doi.org/10.1111/echo.15305Song W, Zhang C, Tang J, Li Y, Jiao T, Lin X, et al. Hypersensitive C-reactive protein as a potential indicator for predicting left ventricular hypertrophy in elderly community-dwelling patients with hypertension. BMC Cardiovasc Disord. 2023;23(1):480. https://doi.org/10.1186/s12872-023-03509-zSong W, Zhang C, Tang J, Li Y, Jiao T, Lin X, et al. Hypersensitive C-reactive protein as a potential indicator for predicting left ventricular hypertrophy in elderly community-dwelling patients with hypertension. BMC Cardiovasc Disord. 2023;23(1):480. https://doi.org/10.1186/s12872-023-03509-zПавлова О.С., Ясюкайть Н.В., Барбук О.А., Денисевич Т.Л., Затолока Н.В., Русских И.И. и др. Ассоциация показателей воспаления и гематологических индексов с гипертрофией левого желудочка у пациентов с артериальной гипертензией. Артериальная гипертензия. 2024;30(1):108–120. https://doi.org/10.18705/1607-419X-2024-2405Pavlova OS, Yasiukaits NV, Barbuk OA, Denisevich TL, Zatoloka NV, Russkikh II, et al. Association of inflammatory and hematological indices with left ventricular hypertrophy in hypertensive patients. Arterial’naya Gipertenziya = Arterial Hypertension. 2024;30(1):108–120. (In Russ.) https://doi.org/10.18705/1607-419X-2024-2405Zeng X, Yang Y. Molecular mechanisms underlying vascular remodeling in hypertension. Rev Cardiovasc Med. 2024;25(2):72. https://doi.org/10.31083/j.rcm2502072Zeng X, Yang Y. Molecular mechanisms underlying vascular remodeling in hypertension. Rev Cardiovasc Med. 2024;25(2):72. https://doi.org/10.31083/j.rcm2502072Bombelli M, Vanoli J, Facchetti R, Maloberti A, Cuspidi C, Grassi G, et al. Impact of the increase in left ventricular mass on the risk of long-term cardiovascular mortality: a prospective cohort study. Hypertension. 2023;80(6):1321–1330. https://doi.org/10.1161/HYPERTENSIONAHA.122.19988Bombelli M, Vanoli J, Facchetti R, Maloberti A, Cuspidi C, Grassi G, et al. Impact of the increase in left ventricular mass on the risk of long-term cardiovascular mortality: a prospective cohort study. Hypertension. 2023;80(6):1321–1330. https://doi.org/10.1161/HYPERTENSIONAHA.122.19988McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368Агеев Ф.Т., Овчинников А.Г. Диастолическая сердечная недостаточность: 20 лет спустя. Актуальные вопросы патогенеза, диагностики и лечения сердечной недостаточности с сохраненной ФВЛЖ. Кардиология. 2023;63(3):3–12. https://doi.org/10.18087/cardio.2023.3.n2376Ageev FT, Ovchinnikov AG. Diastolic heart failure: 20 years later. Сurrent issues of pathogenesis, diagnosis and treatment of heart failure with preserved LVEF. Kardiologiia. 2023;63(3):3–12. (In Russ.) https://doi.org/10.18087/cardio.2023.3.n2376Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861–870. https://doi.org/10.1161/CIRCULATIONAHA.118.034646Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861–870. https://doi.org/10.1161/CIRCULATIONAHA.118.034646Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, et al. How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Heart Journal. 2019;40(40):3297–3317. https://doi.org/10.1093/eurheartj/ehz641Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, et al. How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Heart Journal. 2019;40(40):3297–3317. https://doi.org/10.1093/eurheartj/ehz641Inoue K, Obokata M. Clinical utility of the left atrial strain analysis. J Echocardiogr. 2025;23(3):145–155. https://doi.org/10.1007/s12574-025-00695-xInoue K, Obokata M. Clinical utility of the left atrial strain analysis. J Echocardiogr. 2025;23(3):145–155. https://doi.org/10.1007/s12574-025-00695-xReddy YNV, Obokata M, Egbe A, Yang JH, Pislaru S, Lin G, et al. Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction. Eur J Heart Fail. 2019;21:891–900. https://doi.org/10.1002/ejhf.1464Reddy YNV, Obokata M, Egbe A, Yang JH, Pislaru S, Lin G, et al. Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction. Eur J Heart Fail. 2019;21:891–900. https://doi.org/10.1002/ejhf.1464Lundberg A, Johnson J, Hage C, Bäck M, Merkely B, Venkateshvaran A, et al. Left atrial strain improves estimation of filling pressures in heart failure: a simultaneous echocardiographic and invasive haemodynamic study. Clin Res Cardiol. 2019;108(6):703– 715. https://doi.org/10.1007/s00392-018-1399-8Lundberg A, Johnson J, Hage C, Bäck M, Merkely B, Venkateshvaran A, et al. Left atrial strain improves estimation of filling pressures in heart failure: a simultaneous echocardiographic and invasive haemodynamic study. Clin Res Cardiol. 2019;108(6):703– 715. https://doi.org/10.1007/s00392-018-1399-8Obokata M, Reddy YNV, Borlaug BA. Diastolic dysfunction and heart failure with preserved ejection fraction: understanding mechanisms by using noninvasive methods. JACC: Cardiovascular Imaging. 2020;13(1):245–257. https://doi.org/10.1016/j.jcmg.2018.12.034Obokata M, Reddy YNV, Borlaug BA. Diastolic dysfunction and heart failure with preserved ejection fraction: understanding mechanisms by using noninvasive methods. JACC: Cardiovascular Imaging. 2020;13(1):245–257. https://doi.org/10.1016/j.jcmg.2018.12.034Ye Z, Miranda WR, Yeung DF, Kane GC, Oh JK. Left atrial strain in evaluation of heart failure with preserved ejection fraction. J Am Soc Echocardiogr. 2020;33(12):1490–1499. https://doi.org/10.1016/j.echo.2020.07.020Ye Z, Miranda WR, Yeung DF, Kane GC, Oh JK. Left atrial strain in evaluation of heart failure with preserved ejection fraction. J Am Soc Echocardiogr. 2020;33(12):1490–1499. https://doi.org/10.1016/j.echo.2020.07.020Morris DA, Belyavskiy E, Aravind-Kumar R, Kropf M, Frydas A, Braunauer K, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC: Cardiovascular Imaging. 2018;11:1405–1415. https://doi.org/10.1016/j.jcmg.2017.07.029Morris DA, Belyavskiy E, Aravind-Kumar R, Kropf M, Frydas A, Braunauer K, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC: Cardiovascular Imaging. 2018;11:1405–1415. https://doi.org/10.1016/j. jcmg.2017.07.029Мазур Е.С., Мазур В.В., Баженов Н. Д., Нилова О.В., Николаева Т.О. Деформация левого предсердия в оценке сердечной недостаточности с сохраненной фракцией выброса у больных артериальной гипертензией. Российский кардиологический журнал. 2022;27(8):5099. https://doi.org/10.15829/1560-4071-2022-5099Mazur ES, Mazur VV, Bazhenov ND, Nilova OV, Nikolaeva TO. Left atrial strain in assessing heart failure with preserved ejection fraction in hypertensive patients. Russian Journal of Cardiology. 2022;27(8):5099. (In Russ.) https://doi.org/10.15829/1560-4071-2022-5099Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. https://doi.org/10.1016/j.echo.2016.01.011Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. https://doi.org/10.1016/j.echo.2016.01.011Калинин А.О., Алехин М.Н., Бахс Г., Шипачов П.Н. Оценка состояния миокарда предсердий у здоровых лиц в режиме двухмерной серошкальной деформации. Кардиология. 2010; 2010;50(8):13–20.Kalinin AO, Alekhin MN, Bahs G, Kalnins A, Shipachov PN. Assessment of the state of atrial myocardium by two-dimensional grey-scale deformation in patients with arterial hypertension and mild left ventricular hypertrophy. Kardiologiia. 2010;50(8):13–20. (In Russ.)Алехин М.Н., Калинин А.О. Диастолическая функция левого желудочка: значение глобальной продольной деформации левого предсердия. Ультразвуковая и функциональная диагностика. 2020;(3):91–104. https://doi.org/10.24835/1607-0771-2020-3-91-104Alekhin MN, Kalinin AO. Left ventricular diastolic function: value of left atrial global longitudinal strain. Ultrasound & Functional Diagnostics. 2020;(3):91–104. (In Russ.) https://doi.org/10.24835/1607-0771-2020-3-91-104Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2017;30(1):59–70.e8. https://doi.org/10.1016/j.echo.2016.09.007Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2017;30(1):59–70.e8. https://doi.org/10.1016/j.echo.2016.09.007Miranda-Aquino T, Hernandez-del RJE, Perez-Topete SE, González-Padilla C, Lomelí-Sánchez ÓS, del Cid-Porras C, et al. Impact of the diastolic dysfunction in the left atrial strain in patients with ischemic heart disease. A cross-sectional study. Cardiovasc Metab Sci. 2021;32(4):170–178. https://doi.org/10.35366/102767Miranda-Aquino T, Hernandez-del RJE, Perez-Topete SE, González-Padilla C, Lomelí-Sánchez ÓS, del Cid-Porras C, et al. Impact of the diastolic dysfunction in the left atrial strain in patients with ischemic heart disease. A cross-sectional study. Cardiovasc Metab Sci. 2021;32(4):170–178. https://doi.org/10.35366/102767Перуцкий Д. Н., Обрезан А. Г., Осипова О. А., Зарудский А. А. Функция левого предсердия у больных хронической сердечной недостаточностью. Кардиоваскулярная терапия и профилактика. 2022;21(6):3265. https://doi.org/10.15829/1728-8800-2022-3265Perutsky DN, Obrezan AG, Osipova OA, Zarudsky AA. Left atrial function in patients with heart failure. Cardiovascular Therapy and Prevention. 2022;21(6):3265. (In Russ.) https://doi.org/10.15829/1728-8800-2022-3265Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology / American Heart Association joint committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. https://doi.org/10.1161/CIR.0000000000001063Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology / American Heart Association joint committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. https://doi.org/10.1161/CIR.0000000000001063Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. J Heart Lung Transplant. 2002;21(2):189–203. https://doi.org/10.1016/s1053-2498(01)00776-8Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. J Heart Lung Transplant. 2002;21(2):189–203. https://doi.org/10.1016/s1053-2498(01)00776-8Драпкина О.М., Бойцов С.А., Агеев Ф.Т., Бланкова З.Н., Джиоева О.Н., Дроздова Л.Ю. и др. Диспансерное наблюдение пациентов с хронической сердечной недостаточностью врачом-терапевтом в первичном звене здравоохранения. Методические рекомендации. Первичная медико-санитарная помощь. 2025;2(1):53–114. https://doi.org/10.15829/3034-4123-2025-39Drapkina OM, Boytsov SA, Ageev FT, Blankova ZN, Dzhioeva ON, Drozdova LY, et al. Outpatient follow-up of patients with chronic heart failure by a general practitioner in primary health care. Guidelines. Primary Health Care (Russian Federation). 2025;2(1):53–114. (In Russ.) https://doi.org/10.15829/3034-4123-2025-39Dong G. Development and challenges of pre-heart failure with preserved ejection fraction. Rev Cardiovasc Med. 2023;24(9):274. https://doi.org/10.31083/j.rcm2409274Dong G. Development and challenges of pre-heart failure with preserved ejection fraction. Rev Cardiovasc Med. 2023;24(9):274. https://doi.org/10.31083/j.rcm2409274Plitt GD, Spring JT, Moulton MJ, Agrawal DK. Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction. Expert Review of Cardiovascular Therapy. 2018;16:579–589. https://doi.org/10.1080/14779072.2018.1497485Plitt GD, Spring JT, Moulton MJ, Agrawal DK. Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction. Expert Review of Cardiovascular Therapy. 2018;16:579–589. https://doi.org/10.1080/14779072.2018.1497485Bayes-Genis A, Bisbal F, Núñez J, Santas E, Lupón J, Rossignol P, et al. Transitioning from preclinical to clinical heart failure with preserved ejection fraction: a mechanistic approach. J Clin Med. 2020;9(4):1110. https://doi.org/10.3390/jcm9041110Bayes-Genis A, Bisbal F, Núñez J, Santas E, Lupón J, Rossignol P, et al. Transitioning from preclinical to clinical heart failure with preserved ejection fraction: a mechanistic approach. J Clin Med. 2020;9(4):1110. https://doi.org/10.3390/jcm9041110Bisbal F, Baranchuk A, Braunwald E, Bayés de Luna A, Bayés-Genís A. Atrial failure as a clinical entity: JACC review topic of the week. JACC. 2020;75(2):222–232. https://doi.org/10.1016/j.jacc.2019.11.013Bisbal F, Baranchuk A, Braunwald E, Bayés de Luna A, Bayés-Genís A. Atrial failure as a clinical entity: JACC review topic of the week. JACC. 2020;75(2):222–232. https://doi.org/10.1016/j.jacc.2019.11.013Хэ С., Ян С., Го П., Ран Х. Оценка функции левого предсердия у пациентов с гипертонической болезнью и сохраненной фракцией выброса левого желудочка с использованием трехмерной визуализации speckle tracking в реальном времени. Кардиология. 2025;65(8):63–70. https://doi.org/10.18087/cardio.2025.8.n2856He X, Yang X, Guo P, Ran H. Evaluation of left atrial function in patients with hypertensive heart disease and preserved ejection fraction using real-time, three-dimensional speckle tracking imaging. Kardiologiia. 2025;65(8):63–70. (In Russ.) https://doi.org/10.18087/cardio.2025.8.n2856Habibi M, Chahal H, Opdahl A, Gjesdal O, Helle-Valle TM, Heckbert SR, et al. Association of CMR-measured LA function with heart failure development: Results from the MESA study. JACC Cardiovasc Imaging. 2014;7(6):570–579. https://doi.org/10.1016/j.jcmg.2014.01.016Habibi M, Chahal H, Opdahl A, Gjesdal O, Helle-Valle TM, Heckbert SR, et al. Association of CMR-measured LA function with heart failure development: Results from the MESA study. JACC Cardiovasc Imaging. 2014;7(6):570–579. https://doi.org/10.1016/j.jcmg.2014.01.016Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett JC Jr, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology / American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–1570. https://doi.org/10.1161/CIRCULATIONAHA.106.666818Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett JC Jr, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology / American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–1570. https://doi.org/10.1161/CIRCULATIONAHA.106.666818Meng W, Yang H, Ren Z, Wu J, Zheng Y, Zhao S, et al. Prognosis of early-stage HFpEF in the community-dwelling elderly: The Northern Shanghai Study. ESC Heart Fail. 2025;12(1):229– 238. https://doi.org/10.1002/ehf2.15060Meng W, Yang H, Ren Z, Wu J, Zheng Y, Zhao S, et al. Prognosis of early-stage HFpEF in the community-dwelling elderly: The Northern Shanghai Study. ESC Heart Fail. 2025;12(1):229– 238. https://doi.org/10.1002/ehf2.15060Zheng P-P, Yao S-M, Guo D, Cui L-l, Miao G-B, Dong W, et al. Prevalence and prognostic value of heart failure stages: an elderly inpatient based cohort study. Front Med. 2021;8:639453. https://doi.org/10.3389/fmed.2021.639453Zheng P-P, Yao S-M, Guo D, Cui L-l, Miao G-B, Dong W, et al. Prevalence and prognostic value of heart failure stages: an elderly inpatient based cohort study. Front Med. 2021;8:639453. https://doi.org/10.3389/fmed.2021.639453Шляхто Е.В. Классификация сердечной недостаточности: фокус на профилактику. Российский кардиологический журнал. 2023;28(1):5351. https://doi.org/10.15829/1560-4071-2023-5351Shlyakhto EV. Classification of heart failure: focus on prevention. Russian Journal of Cardiology. 2023;28(1):5351. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5351Anwar AM. Incremental diagnostic and prognostic utility of left atrial deformation in heart failure using speckle tracking echocardiography. Heart Fail Rev. 2024;29(3):713–727. https://doi.org/10.1007/s10741-024-10392-zAnwar AM. Incremental diagnostic and prognostic utility of left atrial deformation in heart failure using speckle tracking echocardiography. Heart Fail Rev. 2024;29(3):713–727. https://doi.org/10.1007/s10741-024-10392-zОвчинников А.Г., Агеев Ф.Т., Алёхин М.Н., Беленков Ю.Н., Васюк Ю.А., Галявич А. С. и др. Диастолическая трансторакальная стресс-эхокардиография с дозированной физической нагрузкой в диагностике сердечной недостаточности с сохраненной фракцией выброса: показания, методология, интерпретация результатов. Согласованное мнение экспертов, выработанное под эгидой ФГБУ «Национальный медицинский исследовательский центр кардиологии» МЗ РФ, Общества специалистов по сердечной недостаточности (ОССН) и Российской ассоциации специалистов ультразвуковой диагностики в медицине (РАСУДМ). Кардиология. 2020;60(12):48–63. https://doi.org/10.18087/cardio.2020.12.n1219Ovchinnikov AG, Ageev FT, Alekhin MN, Belenkov YuN, Vasyuk YuA, Galyavich AS, et al. The role of diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation. Expert consensus developed under the auspices of the National Medical Research Center of Cardiology, Society of Experts in Heart Failure (SEHF), and Russian Association of Experts in Ultrasound Diagnosis in Medicine (REUDM). Kardiologiia. 2020;60(12):48–63. (In Russ.) https://doi.org/10.18087/cardio.2020.12.n1219Thomas L, Muraru D, Popescu BA, Sitges M, Rosca M, Pedrizzetti G, et al. Evaluation of left atrial size and function: relevance for clinical practice. J Am Soc Echocardiogr. 2020;33:934– 952. https://doi.org/10.1016/j.echo.2020.03.021Thomas L, Muraru D, Popescu BA, Sitges M, Rosca M, Pedrizzetti G, et al. Evaluation of left atrial size and function: relevance for clinical practice. J Am Soc Echocardiogr. 2020;33:934– 952. https://doi.org/10.1016/j.echo.2020.03.021Freed BH, Daruwalla V, Cheng JY, Aguilar FG, Beussink L, Choi A, et al. Prognostic utility and clinical significance of cardiac mechanics in heart failure with preserved ejection fraction: importance of left atrial strain. Circ Cardiovasc Imaging. 2016;9(3):e003754. https://doi.org/10.1161/CIRCIMAGING.115.003754Freed BH, Daruwalla V, Cheng JY, Aguilar FG, Beussink L, Choi A, et al. Prognostic utility and clinical significance of cardiac mechanics in heart failure with preserved ejection fraction: importance of left atrial strain. Circ Cardiovasc Imaging. 2016;9(3):e003754. https://doi.org/10.1161/CIRCIMAGING.115.003754Hieda M, Sarma S, Hearon CM, Jr, Dias KA, Martinez J, Samels M, et al. Increased myocardial stiffness in patients with highrisk left ventricular hypertrophy: the hallmark of stage-b heart failure with preserved ejection fraction. Circulation. 2020;141(2):115-123. https://doi.org/10.1161/CIRCULATIONAHA.119.040332Hieda M, Sarma S, Hearon CM, Jr, Dias KA, Martinez J, Samels M, et al. Increased myocardial stiffness in patients with highrisk left ventricular hypertrophy: the hallmark of stage-b heart failure with preserved ejection fraction. Circulation. 2020;141(2):115-123. https://doi.org/10.1161/CIRCULATIONAHA.119.040332Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;8(1):14. https://doi.org/10.1186/1476-7120-8-14Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;8(1):14. https://doi.org/10.1186/1476-7120-8-14Morris DA, Takeuchi M, Krisper M, Köhncke C, Bekfani T, Carstensen T, et al. Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study. Eur Heart J Cardiovasc Imaging. 2015;16(4):364–372. https://doi.org/10.1093/ehjci/jeu219Morris DA, Takeuchi M, Krisper M, Köhncke C, Bekfani T, Carstensen T, et al. Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study. Eur Heart J Cardiovasc Imaging. 2015;16(4):364–372. https://doi.org/10.1093/ehjci/jeu219Singh A, Medvedofsky D, Mediratta A, Balaney B, Kruse E, Ciszek B, et al. Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures. Int J Cardiovasc Imaging. 2019;35(1):23–32. https://doi.org/10.1007/s10554-018-1425-ySingh A, Medvedofsky D, Mediratta A, Balaney B, Kruse E, Ciszek B, et al. Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures. Int J Cardiovasc Imaging. 2019;35(1):23–32. https://doi.org/10.1007/s10554-018-1425-yInoue K, Khan FH, Remme EW, Ohte N, García-Izquierdo E, Chetrit M, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021;23(1):61–70. https://doi.org/10.1093/ehjci/jeaa415Inoue K, Khan FH, Remme EW, Ohte N, García-Izquierdo E, Chetrit M, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021;23(1):61–70. https://doi.org/10.1093/ehjci/jeaa415Овчинников А. Г., Потехина А. В., Филатова А. Ю., Свирида О. Н., Шогенова М. Х., Соболевская М. С. и др. Роль левого предсердия в патогенезе сердечной недостаточности с сохраненной фракцией выброса. Кардиология. 2024;64(11):132– 147. https://doi.org/10.18087/cardio.2024.11.n2799Ovchinnikov AG, Potekhina AV, Filatova AYu, Svirida ON, Shogenova MKh, Sobolevskaya MS, et al. The role of the left atrium in the pathogenesis of heart failure with preserved ejection fraction. Kardiologiia. 2024;64(11):132–147. (In Russ.) https://doi.org/10.18087/cardio.2024.11.n2799Coats AJS, Heymans S, Farmakis D, Anker SD, Backs J, Bauersachs J, et al. Atrial disease and heart failure: the common soil hypothesis proposed by the Heart Failure Association of the European Society of Cardiology. Eur Heart J. 2022;43(17):1635. https://doi.org/10.1093/eurheartj/ehac124Coats AJS, Heymans S, Farmakis D, Anker SD, Backs J, Bauersachs J, et al. Atrial disease and heart failure: the common soil hypothesis proposed by the Heart Failure Association of the European Society of Cardiology. Eur Heart J. 2022;43(17):1635. https://doi.org/10.1093/eurheartj/ehac124Ovchinnikov AG, Potekhina AV, Borisov AA, Ibragimova NM, Yushchyuk EN Masenko VP, et al. The contribution of left atrial dysfunction to exercise intolerance in early heart failure with preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. 2020;21(Suppl 1):jez320. https://doi.org/10.1093/ehjci/jez320Ovchinnikov AG, Potekhina AV, Borisov AA, Ibragimova NM, Yushchyuk EN Masenko VP, et al. The contribution of left atrial dysfunction to exercise intolerance in early heart failure with preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. 2020;21(Suppl 1):jez320. https://doi.org/10.1093/ehjci/jez320Bayes-Genis A, Pascual-Figal D, Núñez J. The pre-HFpEF stage: a new entity that requires proper phenotyping for better management. Eur J Prev Cardiol. 2021;28(9):935–936. https://doi.org/10.1177/2047487320902326Bayes-Genis A, Pascual-Figal D, Núñez J. The pre-HFpEF stage: a new entity that requires proper phenotyping for better management. Eur J Prev Cardiol. 2021;28(9):935–936. https://doi.org/10.1177/2047487320902326

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