Disease-Modifying Therapy of Chronic Heart Failure on the Background of Heart Rhythm and Conductivity Disorders (Clinical Case)

封面

如何引用文章

全文:

详细

The article presents a clinical case of the development and progression of chronic heart failure (CHF) in a patient with postinfarction cardiosclerosis after implantation of a permanent pacemaker due to binodal dysfunction. The progression of CHF was exacerbated by the patient's transition to a permanent form of atrial fibrillation. Complex therapy for CHF, including cardiac resynchronization therapy, drug therapy with valsartan + sacubitril, empagliflozin, eplerenone, metoprolol succinate (quadrotherapy) led to a complete recovery of the ejection fraction (EF) of the left ventricle. After the patient stopped taking one of the components of quadrotherapy (valsartan + sacubitril), there was a tendency to decrease in EF. The clinical case emphasizes the importance of the timely transformation of traditional permanent pacing into cardiac resynchronization therapy and the appointment of complex modern drug therapy for CHF. When an improvement or restoration of EF is achieved, it is advisable to continue the therapy against which the improvement was obtained in order to avoid the negative consequences that are possible when the components of the quadrotherapy are cancelled.

作者简介

Tatiana Novikova

North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: novikova-tn@mail.ru
ORCID iD: 0000-0003-4655-0297
SPIN 代码: 3401-0329

MD, Cand.Sci.(Med), Associate professor of departament therapy and cardiology of M.S. Kushakovsky

俄罗斯联邦, 41, st. Kirochnaya, St. Petersburg, 191015

Vladimir Novikov

North-Western State Medical University named after I.I. Mechnikov

Email: novikov-vi@mail.ru
ORCID iD: 0000-0002-2493-6300
SPIN 代码: 6909-3377

MD, Doctor of medical sciences, Professor, Head of the Department of Functional Diagnostics

俄罗斯联邦, 41, st. Kirochnaya, , St. Petersburg, 191015

Fatima Bitakova

North-Western State Medical University named after I.I. Mechnikov

Email: Fatima.Bitakova@szgmu.ru
ORCID iD: 0000-0001-6637-8266
SPIN 代码: 8624-7193

MD, Cand.Sci.(Med), Associate professor of departament therapy and cardiology of M.S. Kushakovsky

俄罗斯联邦, 41, st. Kirochnaya, St. Petersburg, 191015

Sergey Saiganov

North-Western State Medical University named after I.I. Mechnikov

Email: sergey.sayganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
SPIN 代码: 2174-6400

MD, Doctor of medical sciences, Professor, Head of the Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky, Rector

俄罗斯联邦, 41, st. Kirochnaya, St. Petersburg, 191015

Vladislava Shcherbakova

North-Western State Medical University named after I.I. Mechnikov

Email: shcher.vl@yandex.ru

4th year student

俄罗斯联邦, 41, st. Kirochnaya, St. Petersburg, 191015

参考

  1. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(26):3599–3726. doi: 10.1093/eurheartj/ehab368
  2. Khronicheskaya serdechnaya nedostatochnost'. Klinicheskie rekomendatsii 2020. 183 p. [Internet]. Available from: https://scardio.ru/rekomendacii/rekomendacii_rko_close/ (In Russ.).
  3. Shlyakhto ЕV. Molecular and genetic aspects of heart failure in diabetic patients. Annals of the Russian Academy of Medical Sciences. 2012;(1):31–37. (In Russ.). doi: 10.15690/vramn.v67i1.107
  4. Vaduganathan M, Claggett BL, Jhund PS, et al. Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. Lancet. 2020;396(10244):121–128. doi: 10.1016/S0140-6736(20)30748-0
  5. 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. J Am Soc Echocardiogr. 2015;28(1):1–39. doi: 10.1016/j.echo.2014.10.003
  6. 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. J Am Soc Echocardiogr. 2016;29(4):277–314. doi: 10.1016/j.echo.2016.01.011
  7. Novikov VI, Novikova TN. Klapannye poroki serdtsa. Moscow: MEDpress-inform, 2020. 159 p. (In Russ.).
  8. McMurray JJV, Packer M, Desai AS, et al. Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial(PARADIGM-HF). Eur J Heart Failure. 2013;15(9):1062–1073. doi: 10.1093/eurjhf/hft052
  9. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2020;42(5):373–498. doi: 10.1093/eurheartj/ehaa612
  10. Glikson M, Nielsen JC, Kronborg MB, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021;42(5):3427–3520. doi: 10.1093/eurheartj/ehab364
  11. McMurray JJV, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371:993–1004. doi: 10.1056/NEJMoa1409077
  12. Desai AS, McMurray JJV, Packer M, et al. Effect of the angiotensin-receptor-neprilysin inhibitor LCZ696 compared with enalapril on mode of death in heart failure patients. Eur Heart J. 2015;36(30):1990–1997. doi: 10.1093/eurheartj/ehv186
  13. Kang D-H, Park S-J, Shin S-H, et al. Angiotensin Receptor Neprilysin Inhibitor for Functional Mitral Regurgitation. Circulation. 2019;139:1354–1365. doi: 10.1161/CIRCULATIONAHA.118.037077
  14. De Diego C, González-Torres L, Núñez JM, et al. Effects of angiotensin-neprilysin inhibition compared to angiotensin inhibition on ventricular arrhythmias in reduced ejection fraction patients under continuous remote monitoring of implantable defibrillator devices. Heart Rhythm. 2018;15(3):395–402. doi: 10.1016/j.hrthm.2017.11.012
  15. Snezhitskiy VA, Kalatsei LV, Matyukevich MC, et al. Clinical Experience of Use of Sacubitril/Valsartan in a Patient with Dilated Cardiomyopathy, Chronic Heart Failure with Reduced Ejection Fraction and Ventricular Arrhythmias. Cardiac Arrhythmias. 2021;1(1):39–48. (In Russ.). doi: 10.17816/cardar65220
  16. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381:1995–2008. doi: 10.1056/NEJMoa1911303
  17. Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383:1413–1424. doi: 10.1056/NEJMoa2022190
  18. Cotter G, Davison BA, Mabazaa A, et al. Medical Therapy of Heart Failure with Reduced Ejection Fraction—A Call for Comparative Research. J Clin Med. 2021;10(9):1803. doi: 10.3390/jcm10091803
  19. Mak K-H. Coronary and mortality risk of novel oral antithrombotic agents: a meta-analysis of large randomised trials. BMJ Open. 2012;2(5):e001592. doi: 10.1136/bmjopen-2012-001592
  20. Novikova TN. Features of anticoagulant therapy of atrial fibrillation in combination with impaired renal function. Kardiologiia. 2021;61(10):81–88. (In Russ.). doi: 10.18087/cardio.2021.10.n1767

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Fragment of ECG monitoring. Explanation in the text

下载 (407KB)
索引源数据
3. Fig. 2

下载 (326KB)
索引源数据
4. Fig. 3. Assessment of myocardial dyssynchrony. Explanation in the text

下载 (498KB)
索引源数据

版权所有 © Novikova T., Novikov V., Bitakova F., Saiganov S., Shcherbakova V., 2022

Creative Commons License
此作品已接受知识共享署名-非商业性使用-禁止演绎 4.0国际许可协议的许可。
##common.cookie##