Широкая распространенность сердечно-сосудистых заболеваний, которые приводят к нарушению гемодинамики с уменьшением сердечного выброса и перфузии тканей, в конечном итоге характеризуется ростом синдрома сердечной недостаточности (СН). В настоящее время 23 миллиона человек по всему миру страдают СН. Пациенты с СН часто предъявляют жалобы и симптомы, которые неспецифичны, особенно на ранних стадиях, что представляет трудности в постановке диагноза и ошибочной тактике лечения. Нейрогуморальная модель развития хронической СН (ХСН) доказала, что в реализации компенсаторных гемодинамических механизмов, функционирующих при СН, ведущая роль принадлежит гиперактивации локальных или тканевых нейрогормонов. В настоящее время натрийуретические пептиды представляют собой золотой стандарт среди сердечных нейроэндокринных маркеров согласно рекомендациям РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр, 2013 г). Высокая распространенность сопутствующей патологии у пожилых пациентов на фоне ХСН привело к необходимости использования комплексного подхода с участием нескольких более чувствительных биомаркеровв диагностике СН. Этот обзор содержит краткое представление последних достижений в области нейроэндокринных маркеров, использующихся в настоящее время в диагностике и прогнозе пациентов с ХСН.
The prevalence of cardiovascular disease, which lead to disruption of hemodynamics and cardiac output decrease in tissue perfusion, eventually syndrome is characterized by growth of heart failure (HF). Currently, 23 million people worldwide suffer from HF. Patients with heart failure often complain and symptoms are nonspecific, especially in the early stages, it presents difficulties in diagnosis and incorrect treatment strategy. Neurohumoral model of chronic heart failure (CHF) has shown that in the implementation of compensatory hemodynamic mechanisms operating at HF, the leading role belongs to the hyperactivation of local tissue or neurohormones. Currently, natriuretic peptides are the gold standard among heart neuroendocrine markers as recommended by RussianSociety of Cardiology for diagnosis and treatment of chronic heart failure (fourth revision, 2013). The high prevalence of comorbidity in older patients on a background of HF led to the need for an integrated approach involving a number of more sensitive biomarkers in the diagnosis of HF. This review provides a brief presentation of the latest achievements in the field of neuroendocrine markers currently used in the diagnosis and prognosis of patients with CHF.
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