cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-2048Research ArticleОБЗОРЫREVIEWSНовые возможности в лечении больных легочной артериальной гипертензией: Европейские рекомендации 2009 годаNew perspectives in pulmonary arterial hypertension treatment: 2009 European recommendationsМартынюкТ. В.MartynyukT. V.

с.н.с. отдела системных гипертензий

trukhiniv@mail.ruНаконечниковС. Н.NakonechnikovS. N.

ученый секретарь

ЧазоваИ. Е.ChazovaI. E.

руководитель отдела системных гипертензий

Институт клинической кардиологии им. А.Л.Мясникова ФГУ “Российский кардиологический научно-производственный комплекс Росмедтехнологии”. МоскваA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex. Moscow201020042010928699Copyright © Мартынюк Т.В., Наконечников С.Н., Чазова И.Е., 20102010Мартынюк Т.В., Наконечников С.Н., Чазова И.Е.Martynyuk T.V., Nakonechnikov S.N., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2048

Легочная артериальная гипертензия (ЛАГ) относится к числу наиболее тяжелых заболеваний сердечнососудистой системы, характеризуется прогрессирующим течением с развитием правожелудочковой сердечной недостаточности и крайне неблагоприятным прогнозом. В сентябре 2009г Европейским Обществом Кардиологов и Европейским Респираторным Обществом была принята новая версия рекомендаций по диагностике и лечению больных ЛАГ. В них рассматриваются средства поддерживающей терапии, обсуждаются данные исследований о применении оральных антикоагулянтов, диуретиков, сердечных гликозидов, оксигенотерапии, специфическая терапия, включающая антагонисты кальция, простаноиды, антагонисты рецепторов эндотелина, ингибиторы фосфодиэстеразы типа 5, а также хирургические методы лечения. Современные медикаментозные подходы с использованием препаратов специфической терапии и их комбинаций открывают новые перспективы эффективного лечения больных ЛАГ, улучшают их прогноз. Результаты мета-анализа 23 рандомизированных исследований показали 43% снижение смертности и 61% снижение частоты госпитализации у больных ЛАГ, получавших специфическую терапию (в среднем лечение продолжалось 14,3 нед.). Препараты специфического лечения за рубежом включены в специальные программы. В России официально для лечения больных ЛАГ одобрен бозентан. В ближайшем будущем ожидается регистрация ингаляционного илопроста и силденафила цитрата.

Pulmonary arterial hypertension (PAH) is one of the most severe cardiovascular disorders. It is characterised by progressing clinical course, right ventricular failure development, and very poor prognosis. In September 2009, the European Society of Cardiology and the European Respiratory Society released a new revision of clinical recommendations on pulmonary hypertension (PH) diagnostics and treatment. The recommendations review the evidence for supportive therapy (oral anticoagulants, diuretics, digitalis medications, and oxygen), specific therapy (calcium antagonists, prostanoids, endothelin receptor antagonists, and phosphodiesterase 5 inhibitors), and surgery. Modern pharmaceutical approaches, including specific therapy medications and their combinations, could increase the effectiveness of PH treatment and improve PH prognosis. The meta-analysis of 23 randomised trials demonstrated that in PAH patients, specific therapy (mean duration 14,3 weeks) decreased mortality and hospitalisation rates by 43% and 61%, respectively. In other countries, specific therapy medications are included into targeted treatment programs. In Russia, only bosentan is officially recommended for PAH treatment, while the registration of inhaled iloprost and sildenafil citrate is expected in the nearest future.

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