cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2020-35-2-13-25cardiotomsk-970Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESЭуволемия как критерий эффективности диуретической терапии при хронической сердечной недостаточности: обзор литературыEuvolemia as a criterion of diuretic therapy efficacy in chronic heart failure: Literature reviewhttps://orcid.org/0000-0002-9488-6900ГарганееваА. А.GarganeevaA. A.

д-р мед. наук, профессор, заведующий отделением патологии миокарда,

634012, Томск, ул. Киевская, 111а

Dr. Sci. (Med.), Professor, Head of the Department of Myocardial Pathology,

111a, Kievskaya str., Tomsk, 634012

aag@cardio-tomsk.ruhttps://orcid.org/0000-0002-8070-2234КужелеваЕ. А.KuzhelevaE. A.

канд. мед. наук, научный сотрудник, отделение патологии миокарда,

634012, Томск, ул. Киевская, 111а

Cand. Sci. (Med.), Research Scientist, Department of Myocardial Pathology, 

111a, Kievskaya str., Tomsk, 634012

snigireva1209@rambler.ruhttps://orcid.org/0000-0002-7285-2048МареевВ. Ю.MareevV. Yu.

д-р мед. наук, профессор, главный научный сотрудник,

119991, Москва, Ленинские горы, 1

Dr. Sci. (Med.), Professor, Chief Research Scientist, Medical Scientific and Educational Center,

1, Leninskie Gory, Moscow, 119991

prof_mareev@ossn.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наукРоссияCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian FederationМедицинский научно-образовательный центр Московского государственного университета имени М.В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian Federation2020040720203521325Copyright © Гарганеева А.А., Кужелева Е.А., Мареев В.Ю., 20202020Гарганеева А.А., Кужелева Е.А., Мареев В.Ю.Garganeeva A.A., Kuzheleva E.A., Mareev V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/970

Хроническая сердечная недостаточность (ХСН) является закономерным исходом всех патологических процессов, затрагивающих сердечно-сосудистую систему, и диагностируется у 1–2% населения в развитых странах. Стратегия ведения пациентов с ХСН, помимо патогенетической фармакотерапии, предполагает назначение диуретических препаратов для купирования синдрома задержки жидкости. Учитывая противоречивые данные по влиянию диуретиков на отдаленный прогноз и клиническое течение ХСН, необходим строгий подход к анализу соотношения риск/польза при выборе конкретного мочегонного препарата, определении его оптимальной дозы и длительности применения. В статье представлен обзор современной литературы по оценке статуса гидратации у больного ХСН. Рассмотрено состояние эуволемии, при котором в организме больного ХСН достигается оптимальный объем жидкости, с позиции оценки эффективности и целесообразности применения диуретической терапии.

Chronic heart failure (CHF) is a typical outcome for all pathological processes affecting the cardiovascular system and is diagnosed in 1–2% of the population in developed countries. The strategy for managing patients with CHF involves the prescription of diuretics for the relief of volume retention syndrome in addition to pathogenetic pharmacotherapy. Considering the confl icting data concerning the effects of diuretics on the long-term prognosis and clinical course of CHF, a strict approach to the analysis of risk/benefit ratio is necessary while choosing a specific diuretic and determining its optimal dose and duration of use. The article reviews state-of-theart literature on the assessment of hydration status in patients with CHF. The euvolemia state, in which the optimal volume of fl uid is achieved in the body of a patient with CHF is viewed from the perspective of evaluating the efficacy and relevance of diuretic therapy.

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The authors declare that there are no conflicts of interest present.