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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">russjcardiol</journal-id><journal-title-group><journal-title xml:lang="ru">Российский кардиологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Cardiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-4071</issn><issn pub-type="epub">2618-7620</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/1560-4071-2023-5448</article-id><article-id custom-type="edn" pub-id-type="custom">JCREUS</article-id><article-id custom-type="elpub" pub-id-type="custom">russjcardiol-5448</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>Принципы диагностики сердечной недостаточности с сохраненной фракцией выброса</article-title><trans-title-group xml:lang="en"><trans-title>Principles for diagnosing heart failure with preserved ejection fraction</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4325-2633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Широков</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Shirokov</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Никита Евгеньевич Щироков — кандидат медицинских наук, врач ультразвуковой диагностики, научный сотрудник лаборатории инструментальной диагностики научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">shirokov.ne@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1436-8853</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ярославская</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Yaroslavskaya</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Елена Ильинична Ярославская — доктор медицинских наук, ведущий научный сотрудник, заведующий лабораторией инструментальной диагностики научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">yaroslavskayae@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4993-056X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Криночкин</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krinochkin</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Владиславович Криночкин — кандидат медицинских наук, заведующий отделением ультразвуковой диагностики, старший научный сотрудник лаборатории инструментальной диагностики научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">krin@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8280-2028</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мусихина</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Musikhina</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наталья Алексеевна Мусихина — кандидат медицинских наук, ведущий научный  сотрудник, заведующий отделением неотложной кардиологии научного отдела клинической кардиологии.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">Musihina@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4472-8821</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гизатулина</surname><given-names>Т. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Gizatulina</surname><given-names>T. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татьяна Прокопьевна Гизатулина — доктор медицинских наук, ведущий научный  сотрудник, заведующий отделением нарушений ритма сердца научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">GizatulinaTP@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7443-2952</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Енина</surname><given-names>Т. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Enina</surname><given-names>T. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татьяна Николаевна Енина — доктор медицинских наук, ведущий научный  сотрудник отделения артериальной гипертонии и коронарной недостаточности.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">Enina@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6251-4179</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петелина</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Petelina</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татьяна Ивановна Петелина — доктор медицинских наук, ведущий научный  сотрудник отделения артериальной гипертонии и коронарной недостаточности, заведующий лабораторией клинико-диагностических и молекулярно-генетических исследований научного отдела клинической кардиологии.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">Petelina@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5389-0973</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солдатова</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Soldatova</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анна Михайловна Солдатова — доктор медицинских наук, старший научный сотрудник лаборатории инструментальной диагностики научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">amsoldatova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5479-0859</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Самойлова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Samoilova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Петровна Самойлова — кандидат медицинских наук, врач-кардиолог, научный сотрудник отделения артериальной гипертонии и коронарной недостаточности научного отдела клинической кардиологии.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">samoilova@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-2060-6720</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Погорелов</surname><given-names>Н. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Pogorelov</surname><given-names>N. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Николай Олегович Погорелов — лаборант-исследователь лаборатории инструментальной диагностики научного отдела инструментальных методов исследования.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">kolya_pogorelovv@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3620-0659</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гапон</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Gapon</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Людмила Ивановна Гапон — доктор медицинских наук, профессор, заслуженный деятель науки Российской Федерации, заведующий научным отделом клинической кардиологии, научный руководитель отделения артериальной гипертонии и коронарной недостаточности.</p><p>Томск</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">Gapon@infarkta.net</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Тюменский кардиологический научный центр, Томский национальный исследовательский медицинский центр РАН</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tyumen Cardiology Research Center, Tomsk National Research Medical Center</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>12</day><month>09</month><year>2023</year></pub-date><volume>28</volume><issue>3S</issue><issue-title>Образование</issue-title><fpage>5448</fpage><lpage>5448</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Широков Н.Е., Ярославская Е.И., Криночкин Д.В., Мусихина Н.А., Гизатулина Т.П., Енина Т.Н., Петелина Т.И., Солдатова А.М., Самойлова Е.П., Погорелов Н.О., Гапон Л.И., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Широков Н.Е., Ярославская Е.И., Криночкин Д.В., Мусихина Н.А., Гизатулина Т.П., Енина Т.Н., Петелина Т.И., Солдатова А.М., Самойлова Е.П., Погорелов Н.О., Гапон Л.И.</copyright-holder><copyright-holder xml:lang="en">Shirokov N.E., Yaroslavskaya E.I., Krinochkin D.V., Musikhina N.A., Gizatulina T.P., Enina T.N., Petelina T.I., Soldatova A.M., Samoilova E.P., Pogorelov N.O., Gapon L.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://russjcardiol.elpub.ru/jour/article/view/5448">https://russjcardiol.elpub.ru/jour/article/view/5448</self-uri><abstract><p>Низкоинтенсивное системное воспаление, миокардиальный стресс и фиброз внеклеточного матрикса приводят к сердечной недостаточности с сохраненной фракцией выброса (СНсФВ). Для выявления СНсФВ рекомендованы диагностический алгоритм HFA-PEFF и шкала H2FPEF. Низкое соответствие результатов их применения служит причиной совершенствования способов диагностики СНсФВ. Современная инструментальная диагностика этого синдрома включает оценку давления заполнения левого желудочка при проведении диастолического стресс-теста. Перспективным может быть фазовый анализ деформации левого предсердия при эхокардиографии покоя для заключения об увеличении среднего давления в левом предсердии. Исследовательский интерес растет в отношении биомаркеров, участвующих в регуляции синтеза коллагена. В совокупности инструментальная и лабораторная диагностика помогают составить комплексную характеристику последовательного морфофункционального ремоделирования сердца, увеличивая возможности выявления СНсФВ.</p></abstract><trans-abstract xml:lang="en"><p>Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хроническая сердечная недостаточность</kwd><kwd>диастолическая дисфункция</kwd><kwd>диастолический стресс-тест</kwd><kwd>левое предсердие</kwd><kwd>миокардиальный стресс</kwd></kwd-group><kwd-group xml:lang="en"><kwd>heart failure</kwd><kwd>diastolic dysfunction</kwd><kwd>diastolic stress test</kwd><kwd>left atrium</kwd><kwd>myocardial stress</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Dunlay SM, Roger VL, Weston SA, et al. Longitudinal changes in ejection fraction in heart failure patients with preserved and reduced ejection fraction. 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