SURUNKALI YURAK YETISHMOVCHILIGI RIVOJLANISHINING PATOFIZIOLOGIK MEXANIZMLARI VA DAVOLASH STRATEGIYALARI

Shohjahon Rahmatulloyev

Authors

Shohjahon Rahmatulloyev Yangiyer shahar Tibbiyot birlashmasi Shoshilinch tibbiy yordam bo‘limi navbatchi terapevti Author

Keywords:

surunkali yurak yetishmovchiligi, patofiziologiya, yurak remodellashtirilishi, neyrogumoral faollashuv

Abstract

Mazkur maqolada surunkali yurak yetishmovchiligining rivojlanishida ishtirok etuvchi asosiy patofiziologik mexanizmlar hamda zamonaviy davolash strategiyalari kompleks tahlil qilingan. Yurak chiqishining pasayishi, simpatik nerv tizimi va renin–angiotenzin–aldosteron tizimining uzoq muddatli faollashuvi, suyuqlik va natriyning ushlanib qolishi, yurak remodellashtirilishi, miokard fibrozining kuchayishi, endotelial disfunksiya va yallig‘lanish jarayonlarining kasallik rivojlanishidagi o‘rni yoritilgan. Shuningdek, yurak yetishmovchiligining ejeksiya fraksiyasi pasaygan, biroz pasaygan va saqlangan shakllarida qo‘llaniladigan farmakoterapiya yondashuvlari ko‘rib chiqilgan. Angiotenzin retseptori–neprilizin ingibitorlari, beta-adrenoblokatorlar, mineralokortikoid retseptorlari antagonistlari, SGLT2 ingibitorlari va diuretiklarning klinik ahamiyati tahlil qilingan. Tadqiqot natijalari surunkali yurak yetishmovchiligini boshqarishda patofiziologik mexanizmlarga asoslangan, individual va kompleks davolash yondashuvining muhimligini ko‘rsatadi.

Downloads

Download data is not yet available.

References

1. McDonagh T.A., Metra M., Adamo M., et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2021;42(36):3599–3726.

2. Heidenreich P.A., Bozkurt B., Aguilar D., et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation. 2022;145(18):e895–e1032.

3. Packer M., Coats A.J.S., Fowler M.B., et al. Effect of carvedilol on survival in severe chronic heart failure. New England Journal of Medicine. 2001;344(22):1651–1658.

4. Pitt B., Zannad F., Remme W.J., et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. New England Journal of Medicine. 1999;341(10):709–717.

5. McMurray J.J.V., Solomon S.D., Inzucchi S.E., et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. New England Journal of Medicine. 2019;381:1995–2008.

6. Packer M., Anker S.D., Butler J., et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. New England Journal of Medicine. 2020;383:1413–1424.

7. Solomon S.D., McMurray J.J.V., Claggett B., et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. New England Journal of Medicine. 2022;387:1089–1098.

8. Mann D.L., Bristow M.R. Mechanisms and models in heart failure: the biomechanical model and beyond. Circulation. 2005;111(21):2837–2849.

9. Heineke J., Molkentin J.D. Regulation of cardiac hypertrophy by intracellular signalling pathways. Nature Reviews Molecular Cell Biology. 2006;7:589–600.

10. Braunwald E. The war against heart failure: the Lancet lecture. The Lancet. 2015;385(9970):812–824.

11. Ponikowski P., Voors A.A., Anker S.D., et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2016;37(27):2129–2200.

12. Ponikowski P., Jankowska E.A. Pathogenesis and clinical presentation of acute and chronic heart failure. Cardiology. 2020;145(2):1–12.

13. Iwanaga Y., Nishi I., Furuichi S., et al. B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure. Circulation. 2006;113:1240–1247