The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press26110.17650/1818-8338-2016-10-2-60-66PHARMACOTHERAPYФАРМАКОТЕРАПИЯOPTIMAL USE OF BETA-BLOCKERS IN CASE OF CHRONIC HEART FAILUREОПТИМАЛЬНОЕ ПРИМЕНЕНИЕ БЕТА- АДРЕНОБЛОКАТОРОВ ПРИ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИShostakN. A.ШостакН. А.
Russian Federation

Department of faculty therapy named after academician A.I. Nesterov, 

1 Ostrovityanova St., Moscow, 117997

Кафедра факультетской терапии им. акад. А.И. Нестерова, 

117997, Москва, ул. Островитянова, 1

DemidovaN. A.ДемидоваН. А.
Russian Federation

Department of faculty therapy named after academician A.I. Nesterov, 

1 Ostrovityanova St., Moscow, 117997

Кафедра факультетской терапии им. акад. А.И. Нестерова, 

117997, Москва, ул. Островитянова, 1

shostakkaf@yandex.ruState Budgetary Educational Institution of Higher Professional Education “Pirogov Russian National Research Medical University” of the Ministry of Health of RussiaФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России1504201610260661609201616092016Copyright ©; 2016, Shostak N.A., Demidova N.A.Copyright ©; 2016, Шостак Н.А., Демидова Н.А.2016Shostak N.A., Demidova N.A.Шостак Н.А., Демидова Н.А.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/261

Objective – review current data on the use of beta-blockers (BB) in chronic heart failure (CHF).

Materials and methods. This article discusses beneficial effects of BB administration in CHF patients. It has been demonstrated that decrease in heart rate underlies clinical efficacy of BB therapy in patients with chronic heart failure. We reviewed the question of the necessity to achieve target doses of BB in the treatment of CHF patients. It has been shown that administration of BB in patients with chronic heart failure and reduced left ventricular ejection fraction increase pumping function of heart, and thus reduce the number of hospitalizations for decompensated heart failure, reducing the risk of total and sudden mortality. We demonstrated substantial advantages of β1-selective BB over nonselective ones with respect to their impact on hemodynamics, metabolic processes, rheological parameters of blood and bronchi. We also considered therapeutic tactics in case of BB administration in CHF patients.

Results. Based on the data of the current studies we proved high efficiency and safety of β1-selective BBs in CHF patients.

Conclusion. Correct choice of BB in patients with CHF and decrease in heart rate during the treatment can significantly increase an effectiveness of the treatment.

Цель работы – рассмотреть современные данные по применению бета-адреноблокаторов (ББ) при хронической сердечной недостаточности (ХСН).

Материалы и методы. В статье рассматриваются благоприятные эффекты назначения ББ при ХСН. Продемонстрировано, что основой клинической эффективности терапии ББ при ХСН является снижение частоты сердечных сокращений. Рассмотрен вопрос о необходимости достижения целевых доз ББ при лечении больных ХСН. Показано, что назначение ББ пациентам с ХСН и сниженной фракцией выброса левого желудочка способствует увеличению насосной функции сердца, уменьшению количества госпитализаций по поводу декомпенсации сердечной недостаточности, снижению риска общей и внезапной летальности. Продемонстрированы существенные преимущества β1-селективных ББ перед неселективными в отношении их влияния на гемодинамику, метаболические процессы, реологические параметры крови и бронхи. Рассмотрена тактика назначения ББ при ХСН.

Результаты. На основании данных современных исследований показана высокая эффективность и безопасность назначения β1- селективных ББ больным ХСН.

Заключение. Правильный выбор ББ у больных ХСН и достижение в процессе лечения снижения частоты сердечных сокращений может существенно повысить эффективность лечения.

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