Фенотипы хронической сердечной недостаточности у пациентов с сохраненной фракцией выброса левого желудочка

Хроническая сердечная недостаточность с сохраненной фракцией выброса (ХСНсФВ) – распространенный синдром, который приводит к неблагоприятным исходам. Синдром является достаточно гетерогенным и, по данным различных клинических, генетических, молекулярных, протеомных и других исследований, значительно различается в зависимости от преобладающего патофизиологического механизма. В настоящее время имеются современные методы исследования, такие как изучение протеома, генома и эпикардиальной регуляции, которые позволяют более четко выделить фенотипы. В настоящем обзоре рассматриваются существующие концепции фенотипов при ХСНсФВ, в частности, асептического воспаления, фиброза миокарда, дисметаболии и др. Поиск данных осуществлялся с помощью поисковой системы Pubmed с помощью ключевых слов во временном диапазоне 2010–2025 гг. по следующим тегам: HFpEF, phenotypes, proteome, metabolome, inflammation, fibrosis. В настоящее время имеется ограниченное количество лекарственных препаратов, используемых при ХСНсФВ. Потенциально определение фенотипов у каждого конкретного пациента поможет перейти к персонализированной терапии, например, противовоспалительной терапии при преобладании воспалительного компонента, антифибротической терапии при фибротическом фенотипе и т. п.

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