Статья
Современные эхокардиографические критерии сердечной недостаточности с сохраненной фракцией выброса: не только диастолическая дисфункция
Сердечная недостаточность с сохраненной фракцией выброса (СНсФВ) является распространенным, но трудно диагностируемым заболеванием. СНсФВ ассоциирована с коморбидностью, поэтому симптомы не всегда специфичны, что часто обуславливает длительный диагностический поиск и невозможность лечения основного заболевания и профилактики его осложнений. Основным доступным и экономически выгодным визуализирующим методом диагностики СНсФВ является трансторакальная эхокардиография (ТТ ЭхоКГ). Алгоритмы диагностики СНсФВ были впервые систематизированы и опубликованы в 2019 году, что позволит улучшить ведение пациентов и предупредить развитие серьезных осложнений.
1. Фомин И.В. Хроническая сердечная недостаточность в российской федерации: что сегодня мы знаем и что должны делать. Российский кардиологический журнал. 2016;(8):7-13. doi: 10.15829/1560-4071-2016-8-7-13.
2. Roger VL. Epidemiology of heart failure. Circulation Res. 2013; 113(6):646-59. doi: 10.1161/CIRCRESAHA.113.300268.
3. Seferovic PM, Petrie MC, Filippatos GS, et al. Type 2 diabetes mel-litus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20:853-72. doi:10.1002/ejhf.1170.
4. Ponikowski P, Voors AA, Anker SD, et al. Document R.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975. doi:10.1093/eurheartj/ehw128.
5. Paulus WJ, Tschope C, Sanderson J, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28:2539-50. doi:10.1093/eurheartj/ehm037.
6. Chioncel O, Lainscak M, Seferovic PM, et al. Epidemiology and one-year outcomes in patients with chronic heart failure and preserved,mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2017; 19:1574-85. doi:10.1002/ejhf.813.
7. Triposkiadis F, Giamouzis G, Parissis J, et al. Reframing the association and significance of comorbidities in heart failure. Eur J Heart Fail. 2016;18:744-58. doi:10.1016/j.ijcard.2018.04.001.
8. Beale AL, Meyer P, Marwick TH, et al. Sex differences in cardiovascular pathophysiology: why women are overrepresented in heart failure with preserved ejection fraction. Circulation. 2018; 138:198-205. doi: 10.1161/CIRCULATIONAHA.118.034271.
9. Mohammed SF, Hussain S, Mirzoyev SA, et al. Coronary microvascular rarefaction and myocardial fibrosis in heart failure with preserved ejection fraction. Circulation. 2015;131:550-9. doi:10.1161/CIRCULATIONAHA.114.009625.
10. Westermann D, Lindner D, Kasner M, et al. Cardiac inflammation contributes to changes in the extracellular matrix in patients with heart failure and normal ejection fraction. Circ Heart. Fail. 2011;4:44-52. doi: 10.1161/CIRCHEARTFAILURE.109.931451.
11. Wang C, Fan F, Cao Q, et al. Mitochondrial aldehyde dehydrogenase 2 deficienc aggravates energy metabolism disturbance and diastolic dysfunction in diabetic mice. J Mol Med (Berl). 2016;94:1229-40. doi:10.1007/s00109-016-1449-5.
12. Perseghin G, Ntali G, De Cobelli F, et al. Abnormal left ventricular energy metabolism in obese men with preserved systolic and diastolic functions is associated with insulin resistance. Diabetes Care. 2007;30:1520-6. doi:10.2337/dc06-2429.
13. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17:1321-60. doi:10.1016/j.echo.2016.01.011.
14. Lundberg A, Johnson J, Hage C, et al. Left atrial strain improves estimation of filling pressures in heart failure: a simultaneous echocardiographic and invasive haemodynamic study. Clin Res Cardiol. 2018 Dec 10. doi:10.1007/s00392-018-1399-8.
15. Morris DA, Ma XX, Belyavskiy E, et al. Left ventricular longitudinal systolic function analysed by 2D speckle-tracking echocardiography in heart failure with preserved ejection fraction: a metaanalysis. Open Heart. 2017;4(2):e000630. Published online 2017 Sep 25. doi:10.1136/openhrt-2017000630.
16. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:e147-239. doi:10.1016/j.jacc.2013.05.019.
17. Pieske B, Tschope C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC), Eur Heart J. 2019;00,1-21 CLINICAL RESEARCH. doi:10.1093/eurheartj/ehz641.
18. Opdahl A, Remme EW, Helle-Valle T, et al. Determinants of left ventricular early-diastolic lengthening velocity: independent contributions from left ventricular relaxation, restoring forces, and lengthening load. Circulation. 2009;119:2578-86. doi: 10.1161/CIRCULATIONAHA.108.791681.
19. Graham RJ, Gelman JS, Donelan L, et al. Effect of preload reduction by haemodialysis on new indices of diastolic function. Clin Sci (Lond). 2003;105:499-506. doi:10.1042/CS20030059.
20. Von Bibra H, Paulus WJ, St John Sutton M, et al. Quantification of diastolic dysfunction via the age dependence of diastolic function—impact of insulin resistance with and without type 2 diabetes. Int J Cardiol. 2015;182:368-74. doi:10.1016/j.ijcard.2014.12.005.
21. Kasner M, Westermann D, Steendijk P, et al. Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation. 2007; 116:637-47 doi: 10.1161/CIRCULATIONAHA.106.661983.
22. Kasner M, Westermann D, Lopez B, et al. Diastolic tissue Doppler indexes correlate with the degree of collagen expression and cross-linking in heart failure and normal ejection fraction. J Am Coll Cardiol. 2011;57:977-85. doi: 10.1016/j.jacc.2010.10.024.
23. Shah AM, Claggett B, Kitzman D, et al. Contemporary assessment of left ventricular diastolic function in older adults: the atherosclerosis risk in communities study. Circulation. 2017;135:426-39. doi:10.1161/CIRCULATIONAHA.116.024825.
24. Donal E, Galli E, Fraser AG. Non-invasive estimation of left heart filling pressures: another nail in the coffin for E/e’? Eur J Heart Fail. 2017;19:1661-3. doi:10.1093/eurheartj/suz218.
25. Lam CS, Roger VL, Rodeheffer RJ, et al. Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study. J Am Coll Cardiol. 2009;53:1119-26. doi:10.1016/j.jacc.2008.11.051.
26. Al-Naamani N, Preston IR, Paulus JK, et al. Pulmonary arterial capacitance is an important predictor of mortality in heart failure with a preserved ejection fraction. JACC Heart Fail. 2015;3:467-74. doi:10.1016/j.jchf.2015.01.013.
27. Rosenkranz S, Gibbs JSR, Wachter R, et al. Left ventricular heart failure and pulmonary hypertension. Eur Heart J. 2016;37:942-54. doi:10.1093/eurheartj/ehv512.
28. Kasner M, Westermann D, Steendijk P, et al. Left ventricular dysfunction induced by non severe idiopathic pulmonary arterial hypertension: a pressure-volume relationship study. Am J Respir Crit Care Med. 2012; 186(2): 181-9. doi:10.1164/rccm.201110-1860OC.
29. Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949-3003. doi:10.1093/eurheartj/eht296.
30. Voigt JU, Pedrizzetti G, Lysyansky P, et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/ Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16:1-11. doi:10.1016/j.echo.2014.11.003.
31. Morris DA, Boldt LH, Eichstadt H, et al. Myocardial systolic and diastolic performance derived by 2-dimensional speckle tracking echocardiography in heart failure with normal left ventricular ejection fraction. Circ Heart Fail. 2012;5:610-20. doi: 10.1161/CIRCHEARTFAILURE.112.966564.
32. Carluccio E, Biagioli P, Alunni G, et al. Advantages of deformation indices over systolic velocities in assessment of longitudinal systolic function in patients with heart failure and normal ejection fraction. Eur J Heart Fail. 2011;13:292-302. doi: 10.1093/eurjhf/hfq203.
33. Morris DA, Otani K, Bekfani T, et al. Multidirectional global left ventricular systolic function in normal subjects and patients with hypertension: multicenter evaluation. J Am Soc Echocardiogr. 2014;27:493-500. doi:10.1016/j.echo.2014.01.017.
34. Menting ME, McGhie JS, Koopman LP, et al. Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years. Echocardiography. 2016;33:1665-75. doi:10.1016/j.echo.2017.07.010.
35. Sugimoto T, Dulgheru R, Bernard A, et al. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging. 2017; 18:833-40. doi:10.1093/ehjci/jey018.
36. Kocabay G, Muraru D, Peluso D, et al. Normal left ventricular mechanics by two-dimensional speckle-tracking echocardiography. Reference values in healthy adults. Rev Esp Cardiol (Engl Ed). 2014;67:651-8. doi:10.1016/j.rec.2013.12.009.
37. Stefano GT, Zhao H, Schluchter M, et al. Assessment of echocardiographic left atrial size: accuracy of M-mode and twodimensional methods and prediction of diastolic dysfunction. Echocardiography. 2012;29:37-84. doi: 10.1111/j.1540-8175.2011.01643.x.
38. Moya-Mur J-L, Garcfa-Martfn A, Garcfa-Lledo A, et al. Indexed left atrial volume is a more sensitive indicator of filling pressures and left heart function than is anteroposterior left atrial diameter. Echocardiography. 2010;27:1049-55. doi: 10.1111/j.1540-8175.2010.01216.x.
39. Pritchett AM, Mahoney DW, Jacobsen SJ, et al. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol. 2005;45:87-92. doi:10.1016/j.jacc.2004.09.054.
40. Lang RM, Nanda N, Franke A, et al. Live three-dimensional transthoracic echocardiography: case study world atlas. Echocardiography. 2005;22:95-8. doi: 10.1111/j.0742-2822.2005.20041222.x.
41. Kou S, Caballero L, Dulgheru R, et al. Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study. Eur Heart J Cardiovasc Imaging. 2014;15:680-90. doi:10.1093/ehjci/jet284.
42. Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357-63. doi:10.1016/j.jacc.2006.02.048.
43. Melenovsky V, Hwang SJ, Redfield MM, et al. Left atrial remodeling and function in advanced heart failure with preserved or reduce ejection fraction. Circ Heart Fail. 2015;8:295-303. doi: 10.1161/CIRCHEARTFAILURE.114.001667.
44. Almeida P, Rodrigues J, Lourenco P, et al. Left atrial volume index is critical for the diagnosis of heart failure with preserved ejection fraction. J Cardiovasc Med (Hagerstown). 2018. doi:10.2459/JCM.0000000000000651.
45. Lam CS, Rienstra M, Tay WT, et al. Atrial fibrillationin heart failure with preserved ejection fraction: association with exercise capacity, left ventricular filling pressures, natriuretic peptides, and left atrial volume. JACC Heart Fail. 2017;5:92-8. doi: 10.1016/j.jchf. 2016.10.005.
46. Baltabaeva A, Marciniak M, Bijnens B, et al. Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension. Eur J Echocardiogr. 2008;9:501-8. doi: 10.1016/j.euje.2007.08.004.
47. D’Andrea A, Radmilovic J, Ballo P, et al. Working Group on Echocardiography of the Italian Society of Cardiology. Left ventricular hypertrophy or storage disease? The incremental value of speckle tracking strain bull’s-eye. Echocardiography. 2017; 34:746-59. doi:10.1111/echo.13506.
48. Lang RM, Bierig M, Devereux RB, et al. American Society of Echocardiography’s Nomenclature and Standards Committee, Task Force on Chamber Quantification, American College of Cardiology Echocardiography Committee, American Heart Association, European Association of Echocardiography, European Society of Cardiology. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7:79-108. doi:10.1016/j.echo.2005.10.005.
49. Shah AM, Claggett B, Sweitzer NK, et al. Cardiac structure and function and prognosis in heart failure with preserved ejection fraction: findings from the echocardiographic study of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) Trial. Circ Heart Failure. 2014;7:740-51. doi: 10.1161/CIRCHEARTFAILURE.113.000887
50. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233-70. doi: 10.1016/j.echo.2014.10.003.
51. Tribouilloy C, Rusinaru D, Mahjoub H, et al. Impact of echocardiography in patients hospitalized for heart failure: a prospective observational study. Arch Cardiovasc Dis. 2008;101:465-73. doi:10.1016/j.acvd.2008.06.012.
52. Agha SA, Kalogeropoulos AP, Shih J, et al. Echocardiography and risk prediction in advanced heart failure: incremental value over clinical markers. J Cardiac Fail. 2009;15:586-92. doi: 10.1016/j.cardfail.2009.03.002.