cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2022-2948cardiovascular-2948Research ArticleХРОНИЧЕСКАЯ СЕРДЕЧНАЯ НЕДОСТАТОЧНОСТЬCHRONIC HEART FAILUREОбратное ремоделирование миокарда на фоне модуляции сердечной сократимости у пациентов с хронической сердечной недостаточностью и фибрилляцией предсердийReverse remodeling against the background of cardiac contractility modulation therapy in patients with heart failure and atrial fibrillationhttps://orcid.org/0000-0003-3483-4698СафиуллинаА. А.SafiullinaA. A.

Сафиуллина Альфия Ахатовна — кандидат медицинских наук, научный сотрудник отдела заболеваний миокарда и сердечной недостаточности НИИ кардиологии им. А. Л. Мясникова

Москва

Moscow

a_safiulina@mail.ruhttps://orcid.org/0000-0003-4318-0315УскачТ. М.UskachT. M.

Ускач Татьяна Марковна — доктор медицинских наук , ведущий научный сотрудник отдела заболеваний миокарда и  сердечной недостаточности НИИ кардиологии им. А. Л. Мясникова, профессор кафедры кардиологии

Москва

Moscow

tuskach@mail.ruhttps://orcid.org/0000-0003-0580-393XДобровольскаяС. В.DobrovolskayaS. V.

Добровольская Светлана Валерьевна  — врач отдела ультразвуковых методов исследования

Москва

Moscow

s_dobrovolskaya@mail.ruhttps://orcid.org/0000-0002-3233-1862СаидоваМ. А.SaidovaM. A.

Саидова Марина Абдулатиповна  — доктор медицинских наук, профессор, руководитель отдела ультразвуковых методов исследования

Москва

Moscow

m.saidova@gmail.comhttps://orcid.org/0000-0002-4779-5088МакеевМ. И.MakeevM. I.

Макеев Максим Игоревич — врач отдела ультразвуковых методов исследования

Москва

Moscow

makeevmax@yandex.ruhttps://orcid.org/0000-0001-9234-6129ТерещенкоС. Н.TereshchenkoS. N.

Терещенко Сергей Николаевич — доктор медицинских наук, профессор, руководитель отдела заболеваний миокарда и сердечной недостаточности НИИ кардиологии им. А. Л. Мясникова, заведующий кафедрой кардиологии

Москва

Moscow

stereschenko@yandex.ruФГБУ «Научный медицинский исследовательский центр кардиологии» Минздрава РоссииNational Medical Research Center of CardiologyФГБУ «Научный медицинский исследовательский центр кардиологии» Минздрава России; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииNational Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education20221711202121229482948Copyright © Сафиуллина А.А., Ускач Т.М., Добровольская С.В., Саидова М.А., Макеев М.И., Терещенко С.Н., 20222022Сафиуллина А.А., Ускач Т.М., Добровольская С.В., Саидова М.А., Макеев М.И., Терещенко С.Н.Safiullina A.A., Uskach T.M., Dobrovolskaya S.V., Saidova M.A., Makeev M.I., Tereshchenko S.N.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/2948Цель

Цель. Изучить изменение параметров ремоделирования миокарда у  пациентов с  хронической сердечной недостаточностью (ХСН) со сниженной фракцией выброса (ХСНнФВ) левого желудочка (ЛЖ) и  фибрилляцией предсердий (ФП) на фоне применения терапии модуляции сердечной сократимости (МСС).

Материал и методы

Материал и методы. В группе из 100 пациентов с ХСНнФВ и ФП до имплантации устройства МСС и через 2, 6 и 12 мес. наблюдения проводилась трансторакальная эхокардиография. Все пациенты до операции получали длительную оптимальную медикаментозную терапию ХСН.

Результаты

Результаты. На фоне МСС терапии наблюдается статистически значимый прирост ФВ ЛЖ, уменьшение объемных и линейных размеров ЛЖ и уменьшение объемов левого предсердия у пациентов с ХСНнФВ коронарогенной и некоронарогенной природы, с исходной ФВ ЛЖ < и >35%, а также независимо от формы ФП.

Заключение

Заключение. Применение терапии МСС у  пациентов с  ХСНнФВ и  ФП сопровождалось положительной динамикой обратного ремоделирования миокарда. Необходимо дальнейшее изучение влияния МСС терапии на изменение параметров эхокардиографии в рандомизированных клинических исследованиях.

 

 

Aim

Aim. To study myocardial remodeling in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) against the background of cardiac contractility modulation (CCM) therapy.

Material and methods

Material and methods. In a group of 100 patients with HFrEF and AF, transthoracic echocardiography was performed before CCM device implantation and after 2, 6 and 12 months. All patients received longterm optimal medical therapy for HF before surgery.

Results

Results. Against the background of CCM therapy, there was a  significant increase in left ventricular (LV) ejection fraction, a decrease in LV volume and linear dimensions, a decrease in left atrial volume in patients with coronary and non-coronary HFrEF, with an initial LVEF < and >35%, and also regardless of AF type.

Conclusion

Conclusion. CCM therapy in patients with HFrEF and AF led to favorable myocardial remodeling changes. Further study of CCM effect on  echocardiographic parameters in randomized clinical trials is needed.

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