Обратное ремоделирование миокарда на фоне модуляции сердечной сократимости у пациентов с хронической сердечной недостаточностью и фибрилляцией предсердий

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. 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. 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. 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.

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