docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2022-21-6-13-18docru-35Research ArticleКАРДИОЛОГИЯCARDIOLOGYПостковидный синдром и хроническая сердечная недостаточность: актуальные вопросыPostcovid Syndrome and Chronic Heart Failure: Current Issueshttps://orcid.org/0000-0001-9348-9025ГамаюновД. Ю.GamayunovD. Yu.

Гамаюнов Данил Юрьевич - ординатор кафедры пропедевтики внутренних болезней

664003, г. Иркутск, ул. Красного Восстания, д. 1

1 Krasnoe Vosstanie Str., Irkutsk, 664003

d.gamayunov@mail.ruhttps://orcid.org/0000-0002-2708-3972КалягинА. Н.KalyaginA. N.

Калягин Алексей Николаевич - д. м. н., профессор, проректор по лечебной работе и последипломному образованию, заведующий кафедрой пропедевтики внутренних болезней

664003, г. Иркутск, ул. Красного Восстания, д. 1

1 Krasnoe Vosstanie Str., Irkutsk, 664003

118 Baykalskaya Str., Irkutsk, 664046

akalagin@mail.ruhttps://orcid.org/0000-0001-6440-1485СиньковаГ. М.SinkovaG. M.

Синькова Галина Михайловна = д. м. н., заместитель министра здравоохранения Иркутской области, профессор кафедры пропедевтики внутренних болезней

664003, г. Иркутск, ул. Красного Восстания, д. 1

1 Krasnoe Vosstanie Str., Irkutsk, 664003

gsink2014@gmail.comРыжковаО. В.RyzhkovaO. V.

Рыжкова Ольга Владимировна - д. м. н., профессор кафедры факультетской терапии

664003, г. Иркутск, ул. Красного Восстания, д. 1

1 Krasnoe Vosstanie Str., Irkutsk, 664003

ovrizkova@mail.ruhttps://orcid.org/0000-0002-8524-7584ВаравкоЮ. О.VaravkoYu. O.

Варавко Юлия Олеговна - к. м. н., доцент кафедры пропедевтики внутренних болезней

664003, г. Иркутск, ул. Красного Восстания, д. 1

1 Krasnoe Vosstanie Str., Irkutsk, 664003

roza1983@mail.ruФГБОУ ВО «Иркутский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Irkutsk State Medical University” of the Ministry of Healthcare of the Russian FederationRussian FederationФГБОУ ВО «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации; ОГБУЗ «Иркутская городская клиническая больница № 1»РоссияFederal State Budgetary Educational Institution of Higher Education “Irkutsk State Medical University” of the Ministry of Healthcare of the Russian Federation; Regional State Budgetary Institution of Health “Irkutsk Municipal Clinical Hospital No. 1”Russian Federation202213022025216ТЕРАПИЯ1318Copyright © Гамаюнов Д.Ю., Калягин А.Н., Синькова Г.М., Рыжкова О.В., Варавко Ю.О., 20252025Гамаюнов Д.Ю., Калягин А.Н., Синькова Г.М., Рыжкова О.В., Варавко Ю.О.Gamayunov D.Y., Kalyagin A.N., Sinkova G.M., Ryzhkova O.V., Varavko Y.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/35

Цель обзора: рассмотреть патогенетическую связь COVID-19 и хронической сердечной недостаточности, понятие «постковидный синдром», особенности ведения данной группы пациентов.Основные положения. Хроническая сердечная недостаточность — предиктор неблагоприятного исхода у больных COVID-19. Ангиотензинпревращающий фермент 2-го типа участвует в проникновении вирусных частиц в клетку. Не исключается прямое вирусное повреждение кардиомиоцитов, возможно кардиотоксическое воздействие противовирусной терапии. Последствия COVID-19 проявляются аритмией, мио- и перикардитом, кардиомиопатией. Кортикостероиды могут привести к декомпенсации хронической сердечной недостаточности. Применение ингибиторов ренин-ангиотензин-альдостероновой системы и β-блокаторов связано с более низкой смертностью.Заключение. Требуется тщательная разработка тактики ведения и реабилитационных мер у пациентов с хронической сердечной недостаточностью в сочетании с постковидным синдромом.

Objective of the Review: To consider the pathogenetic relationship of COVID-19 and chronic heart failure, the concept of “postcovid syndrome”, the peculiarities of management of this group of patients.Key points. Chronic heart failure is a predictor of an unfavorable outcome in patients with COVID-19. Angiotensin converting enzyme 2 is involved in the penetration of viral particles into the cell. Direct viral damage to cardiomyocytes is not excluded, cardiotoxic effects of antiviral therapy are possible. The consequences of COVID-19 are manifested by arrhythmia, myocarditis and pericarditis, cardiomyopathy. Corticosteroids can lead to decompensation of heart failure. The use of renin-angiotensin-aldosterone system inhibitors and β-blockers is associated with lower mortality.Conclusion. Chronic heart failure in combination with postcovid syndrome requires carefully developed patient management tactics and rehabilitation measures.

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