Rational Pharmacotherapy in Cardiology

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For the long time the systolic myocardial dysfunction was traditionally associated with the severity of chronic heart failure (CHF). Increasing number of patients with symptoms of CHF but without systolic dysfunction has drawn the attention of specialists to so-called CHF with preserved ejection fraction. Prognosis in CHF with preserved ejection fraction may be as bad as in CHF with reduced ejection fraction. Significant changes in views on the pathogenesis of CHF led to the creation of new therapeutic approaches in the treatment of this disease. However, at present, convincing evidence base of mortality reduction in patients with CHF with preserved ejection fraction using well-known therapeutic agents is unavailable. It makes conduct active searches for new biological markers of diastolic heart function. Participation of proinflammatory cytokines, in particular GDF-15, in the process of elasticity reduction and relaxation disorders of left ventricular myocardium, may be of great importance in the development of new medical agents designed to delay the progression of CHF with preserved ejection fraction.

About the Authors

O. M. Drapkina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Trubetskaya ul. 8-2, Moscow, 119991 Russia

L. O. Palatkina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Trubetskaya ul. 8-2, Moscow, 119991 Russia


1. Redfield M, et al. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003; 289: 194-202.

2. Drapkina OM, Ashihmin YaI, Ivashkin VT. Complexity of clinical diagnosis and treatment of diastolic congestive heart failure in patients with hypertension. Russian Medical News 2009; XIV (3): 3-17. Russian (Драпкина О.М., Ашихмин Я.И., Ивашкин В.Т. Сложности клинической диагностики и лече-ния диастолической хронической сердечной недостаточности у пациентов с артериальной ги-пертензией. Российские Медицинские Вести 2009; XIV(3): 3-17).

3. Agueyev FT. The modern concept of diastolic heart failure. Cardiovascular Therapy and Prevention 2010; 9 (7): 96-104. Russian (Агеев Ф.Т. Современная концепция диастолической сердечной недо-статочности. Кардиоваскулярная Терапия и Профилактика 2010; 9(7): 96- 104).

4. Owan T, Redfield M. Epidemiology of diastolic heart failure. Prog Cardiovasc Dis 2005; 47: 320-32.

5. Agueyev FT, Danielian MO, Mareev VY, et al. Patients with chronic heart failure in the Russian outpatient practice: contingent features, diagnosis and treatment: a study of AGE-O-CHF. Heart Failure 2004; 5 (1): 4-7. Russian (Агеев Ф.Т., Даниелян М.О., Мареев В.Ю. и соавт. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения: исследование ЭПОХА-О-ХСН. Сердечная Недостаточность 2004; 5(1): 4-7).

6. Lee D, et al. Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the Framingham Heart Study of the National Heart, Lung, and Blood Institute. Circulation 2009; 119: 3070-7.

7. Mottaram P.M., Marwick T.H. Assessment of diastolic function: what the general cardiologist needs to know. Heart 2005; 91(5): 681-95.

8. Drapkina OM, Dubolazova YuV. "Portrait" diastolic heart failure. Arterial Hypertension 2010, 16 (6): 613-20. Russian (Драпкина, О.М., Дуболазова Ю.В. «Портрет» диастолической сердечной не-достаточности. Артериальная Гипертензия 2010;16(6): 613-20.

9. Agueyev FT. The evolution of ideas about the diastolic function. Heart Failure 2000; (2): 48-50. Russian (Агеев Ф.Т. Эволюция представлений о диастолической функции сердца. Сердечная недо-статочность 2000; (2): 48-50).

10. Wang J, Kurrelmeyer K, Torre-Amione G, et al. Systolic and diastolic dyssynchrony in patients with diastolic heart failure and the effect of medical therapy. J Am Coll Cardiol 2007; 49: 88-96.

11. Mareev VY. Changing strategies for treating chronic heart failure. Time b-blockers. Cardiology 1998; (12): 4-11. Russian (Мареев В.Ю. Изменение стратегии лечения хронической сердечной не-достаточности. Время b-адреноблокаторов. Кардиология 1998; (12): 4-11).

12. van Heerebeek L, Franssen CP, Hamdani N, Molecular and cellular basis for diastolic dysfunction. Curr Heart Fail Rep 2012;9(4):293-302.

13. Kass DA, Bronzwaer JG, Paulus WJ. What mechanisms underlie diastolic dysfunction in heart failure? Circ Res 2004;94:1533-42.

14. Braunwald E. Biomarkers in heart failure. N Engl J Med 2008; 358(20):2148-59.

15. Belenkov N., Agueyev FT, Mareev VY. Neurohormones and cytokines in heart failure: a new theory of the old disease. Heart Failure 2000; 1 (4) :135-8. Russian (Беленков Ю. Н., Агеев Ф. Т., Мареев В. Ю. Нейрогормоны и цитокины при сердечной недостаточности: новая теория старого забо-левания. Сердечная Недостаточность 2000; 1(4):135-8).

16. Anker S, Egerer K, Volk H, et al. Elevated soluble CD14 receptors and altered cytokines in chronic heart failure. Am J Cardiol 1997; 79: 1426-30.

17. Levine B, Kalman J, Mayer L, et al. Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. New Engl J Med 1990; 323: 236-41.

18. Kapadia S, Dibbs Z, Kurrelmeyer K, et al. The role of cytokines in the failing human heart. Cardiol Clin 1998; 16: 645-56.

19. Testa M, Yeh M, Lee P, et al. Circulating levels of cytokines and their endogenous modulators in patients with mild to severe congestive heart failure due to coronary artery disease or hypertension. J Am Coll Cardiol 1996; 28: 964-71.

20. Torre-Amione G, Kapadia S, Benedict C, et al. Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: a report from of SOLVD. J Am Coll Cardiol 1996; 27: 1201-6.

21. Damas J, Gullestad L, Ueland T, et al. CXC-chemokines, a new group of cytokines in congestive heart failure-possible role of platelets and monocytes. Cardiovasc Res 2000; 45: 428-36.

22. Sharma R, Coats A, Anker S. The role of inflammatory mediators in chronic heart failure: cytokines, nitricoxide, andendothlin-1. Int J Cardiol 2000; 72: 175-86.

23. Berry C, Clark A. Catabolism in chronic heart failure. Eur Heart J 2000; 21: 521-32.

24. Gong K, Song G, Spiers J, et al. Activation of immune and inflammatory systems in chronic heart failure: novel therapeutic approaches. Int J Clin Pract 2007; 61: 611-21.

25. Clark D, Cleman M, Pfau S, et al. Serum complement activation in congestive heart failure. Am Heart J 2001; 14: 684-90.

26. Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol 2013; 62(4): 263-71.

27. Bradham W, Bozkurt B, Gunasinghe H, et al. Tumor necrosis factor-alpha and myocardial remodeling in progression of heart failure: a current perspective. Cardiovasc Res 2002; 53: 822-30.

28. Siwik D, Chang D, Colucci W. Interleukin-1beta and tumor necrosis factor-alpha decrease collagen synthesis and increase matrix metalloproteinase activity in cardiac fibroblasts in vitro. Circ Res 2000; 86: 1259-65.

29. Sivasubramanian N, Coker M, Kurrelmeyer K, et al. Left ventricular remodeling in transgenic mice with cardiac restricted overexpression of tumor necrosis factor. Circulation 2001; 104: 826-31.

30. Peng J, Gurantz D, Tran V, et al. Tumor necrosis factor-alpha-induced AT1 receptor upregulation enhances angiotensin II-mediated cardiac fibroblast responses that favor fibrosis. Circ Res 2002; 91: 1119-26.

31. Bootcov M. R., Bauskin A., Valenzuela S. M., et al. MIC-1, a novel macrophage inhibitory cytokine, is a divergent member of the TGF-a superfamily cluster. Proc Natl Acad Sci USA 1997; 94: 11514-9.

32. Kempf T, von Haehling S, Peter T, et al. Prognostic utility of growth differentiation factor-15 in patients with chronic heart failure. J Am Coll Cardiol 2007; 50: 1054-60.

33. Stahrenberg R, Edelmann F, Mende M, et al. The novel biomarker growth differentiation factor 15 in heart failure with normal ejection fraction. Eur J Heart Fail 2010; 12: 1309-16.

34. Drapkina OM, Palatkina LO. Markers of cytokine activation and oxidative stress in patients with chronic heart failure. Heart Failure 2013; 14 (6): 341-6. Russian (Драпкина О. М., Палаткина Л. О. Мар-керы цитокиновой активации и оксидативного стресса у больных хронической сердечной не-достаточностью. Сердечная Недостаточность 2013; 14(6): 341-6).

35. Drapkina OM. RAAS and fibrosis. Hepato-cardiac relations. Russian Journal of Medicine 2011; 18: 1136-9. Russian (Драпкина О. М. РААС и фиброз. Гепатокардиальные связи. Русский Медицинский Журнал 2011; 18: 1136-9).

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