Європейські рекомендації 2023 року щодо лікування кардіоміопатій та впровадження їх у практику в Україні

Abstract

In this article we analyzed the main positions of the recommendations of the European Society of Cardiology regarding the treatment of cardiomyopathies and presented the actual issues of implementing recommendations into clinical practice in Ukraine. The diagnostic flowchat of a patient with suspected cardiomyopathy is presented. Five phenotypes of cardiomyopathies are presented with current definition. New fenotype of non-dilated left ventricular cardiomyopathy is presented. The role of various imaging methods in diagnosis of cardiomyopathy phenotype is considered. The role of methods of genetic testing and magnetic resonance imaging of the heart with contrast is determined. The attention is focused on the need to differentiate the etiology of phenotypes and phenocopies of cardiomyopathies for pathogenetic treatment. Methods of assessing the risk of sudden cardiac death in cardiomyopathies and methods of secondary and primary prevention are discussed. Calculators for the risk of sudden death in cardiomyopathies and indications for implantation of a cardioverter-defibrillator are given. The management of patients with atrial fibrillation in various cardiomyopathies is determined. The issue of treatment of heart failure in patients with different phenotypes and ethiology of cardiomyopathies is discussed. Attention is focused on the role of «cardiomyopathy teams» in cardiological centers. An experience of echocardiographic diagnostics of cardiomyopathies, genetic testing, usage of magnetic resonance imaging in cardiomyopathies is presented.