jsmsJournal of Siberian Medical SciencesJournal of Siberian Medical Sciences2542-1174Federal state budgetary educational institution of higher education "Novosibirsk state medical university" of Ministry of Health of the Russian Federation (FSBEI HE NSMU MOH Russia)10.31549/2542-1174-2021-4-134-148jsms-781Research ArticleОБЗОРЫREVIEWОсобенности современной диагностики и фармакотерапии перипартальной кардиомиопатииFeatures of modern diagnostics and pharmacotherapy of peripartum cardiomyopathyМадоновП. Г.MadonovP. G.

Мадонов Павел Геннадьевич — д-р мед. наук, профессор, заведующий кафедрой фармакологии, клинической фармакологии и доказательной медицины 

Pavel G. Madonov — Dr. Sci. (Med.), Professor, Head, Department of Pharmacology, Clinical Pharmacology and Evidence-Based Medicine

ХидироваЛ. Д.KhidirovaL. D.

Хидирова Людмила Даудовна  — д-р мед. наук, доцент кафедры фармакологии, клинической фармакологии и доказательной медицины 

630091, г. Новосибирск, Красный пр., 52

Lyudmila D. Khidirova  — Dr. Sci. (Med.), Associate Professor, Department of Pharmacology, Clinical Pharmacology and Evidence-Based Medicine 

52, Krasny Prospect, Novosibirsk, 630091 

h_ludmila73@mail.ruКазанцеваВ. Д.KazantsevaV. D.

Казанцева Валерия Дмитриевна — клинический ординатор 

Valeria D. Kazantseva — Clinical Resident 

ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияNovosibirsk State Medical UniversityRussian FederationГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии» Минздрава Московской областиРоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian Federation20212001202204134148Copyright © Мадонов П.Г., Хидирова Л.Д., Казанцева В.Д., 20222022Мадонов П.Г., Хидирова Л.Д., Казанцева В.Д.Madonov P.G., Khidirova L.D., Kazantseva V.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://jsms.elpub.ru/jour/article/view/781

В обзоре рассматриваются особенности современной диагностики, фармакотерапии и профилактики перипартальной кардиомиопатии (ППКМ). Обсуждается значение современных маркеров ППКМ: PAI-1, miR-146a, 16 kDа-PRL, sFlt-1/PlGF, интерферон-гамма, асимметричный диметиларгинин и роль инструментальных методов диагностики (эхокардиография, магнитно-резонансная томография), использование которых зависит от сроков беременности и течения ППКМ. Приводятся сведения о показаниях, осложнениях и клиническом опыте использования основных фармакологических препаратов, применяемых в лечении ППКМ с учетом их возможного неблагоприятного влияния на плод и лактацию. Рассматривается новый алгоритм лечения ППКМ, названный концепцией BOARD (бромокриптин, пероральная терапия хронической сердечной недостаточности (ХСН), антикоагулянты, вазодилататоры и диуретики), в котором к стандартной терапии ХСН добавлено применение бромокриптина и антикоагулянтов, а также профилактические мероприятия по ведению пациенток с ППКМ с учетом риска рецидива при стойкой дисфункции левого желудочка миокарда во время и после беременности.

The review considers the features of modern diagnostics, pharmacotherapy and prevention of peripartum cardiomyopathy (PPCM). The significance of modern markers of PPCM is discussed: PAI-1, miR-146a, 16 kDa-PRL, sFlt-1/PlGF, interferongamma, asymmetric dimethylarginine and the role of diagnostic tests (echocardiography, magnetic resonance imaging), the use of which depends on gestational age and the course of PPCM. The information on indications, complications and clinical experience of the use of the main pharmacological drugs used in the treatment of PPCM, taking into account their possible adverse effects on the fetus and lactation, is given. A new algorithm for the treatment of PPCM, called the BOARD concept (bromocriptine, oral therapy of chronic heart failure (CHF), anticoagulants, vasodilators and diuretics), is being considered, in which the use of bromocriptine and anticoagulants is added to the conventional therapy of CHF, as well as preventive measures for the management of patients with PPCM, taking into account the risk of relapse with persistent left ventricular dysfunction during and after pregnancy.

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