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Kardiologiia ; 60(12): 13-47, 2021 Jan 19.
Artigo em Russo | MEDLINE | ID: mdl-33522467


The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations.

Diuréticos , Insuficiência Cardíaca , Doença Crônica , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Federação Russa
Kardiologiia ; 60(12): 48-63, 2021 Jan 19.
Artigo em Russo | MEDLINE | ID: mdl-33522468


Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.

Pesquisa Biomédica , Cardiologia , Insuficiência Cardíaca , Consenso , Ecocardiografia , Ecocardiografia sob Estresse , Teste de Esforço , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Federação Russa , Volume Sistólico , Função Ventricular Esquerda , Carga de Trabalho
Kardiologiia ; 59(7): 68-75, 2019 Jul 19.
Artigo em Russo | MEDLINE | ID: mdl-31322092


Transthoracic echocardiography is the most frequently used method for detection of impaired contractility of the left ventricle. In most cases, assessment of contractility is carried out visually "by eye", what increases its subjectivity, is operator-dependent in nature and requires a high level of clinical training and experience of the researcher. Currently in the arsenal of a specialist in echocardiography for quantification of left ventricular contractility sometimes is used tissue Doppler echocardiography, however, this method requires special settings of the image (high frame rate, the allocation of zones of interest), depends on the scanning angle and on operator qualification, has high intra - and inter-operator variability, and significantly increases the duration of the study. Therefore, this method has not received wide clinical application. In the 2000s years an innovative technique of speckle tracking emerged, which, unlike tissue Doppler echocardiography is efficient, does not burden a researcher with time costs, has a low intra - and inter- operator variability, does not depend on scan angle. In recent years, this technology is actively implemented in clinical practice for detection of subclinical impairment of the functional state of the myocardium in different diseases and syndromes: arterial hypertension, ischemic heart disease, valvular defects, and congenital heart disease, heart failure, cardiomyopathy of different etiology.

Ecocardiografia , Cardiopatias Congênitas , Ecocardiografia Doppler , Ventrículos do Coração , Humanos
Ter Arkh ; 88(10): 93-98, 2016.
Artigo em Russo | MEDLINE | ID: mdl-28635857


The presence of metabolic syndrome (MS) in a patient allows him to be assigned to a group at high risk for atherosclerosis, cardiovascular events, coronary heart disease, and type 2 diabetes mellitus. In addition, MS negatively affects not only the heart and vessels, but also kidney function, which leads to chronic kidney disease (CKD). MS is pathogenetically associated with CKD and is an independent prognostic factor of the development of the latter, namely, the involvement of the kidney frequently determines prognosis and quality of life in these patients. The paper gives a modern view on the concept of MS and CKD and considers its main diagnostic criteria, etiology, and pathogenesis. The study of the relationships between MS and CKD may suggest that the high prevalence of kidney dysfunction in the general population is largely determined by metabolic nephropathies, including obesity-related nephropathy. The identification of risk factors and poor prognostic markers in this category of patients seems to be extremely important for the early diagnosis of the disease and their timely elimination is one of the main approaches to the comprehensive prevention of CKD in these patients.

Síndrome Metabólica/complicações , Obesidade/complicações , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Qualidade de Vida , Insuficiência Renal Crônica , Fatores de Risco