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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">kpccz</journal-id><journal-title-group><journal-title xml:lang="ru">Комплексные проблемы сердечно-сосудистых заболеваний</journal-title><trans-title-group xml:lang="en"><trans-title>Complex Issues of Cardiovascular Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-1278</issn><issn pub-type="epub">2587-9537</issn><publisher><publisher-name>Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17802/2306-1278-2021-10-1-73-82</article-id><article-id custom-type="elpub" pub-id-type="custom">kpccz-818</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АНАЛИТИЧЕСКИЙ ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ANALYTICAL REVIEW</subject></subj-group></article-categories><title-group><article-title>Перипартальная кардиомиопатия: эпидемиология, патогенез, акушерская тактика</article-title><trans-title-group xml:lang="en"><trans-title>Peripartum cardiomyopathy: epidemiology, pathophysiology, and management</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6599-9906</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рудаева</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rudaeva</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рудаева Елена Владимирова - кандидат медицинских наук, доцент кафедры акушерства и гинекологии им. Г.А. Ушаковой.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Rudaeva Elena V. - Ph.D., Associate Professor at the Department of Obstetrics and Gynecology named G.A. Ushakova, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3317-1351</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хмелева</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Khmeleva</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хмелева Ирина Анатольевна - заведующая отделением кардиологии.пр. Октябрьский, 22, Кемерово, 650066.</p></bio><bio xml:lang="en"><p>Khmeleva Irina A. - M.D., the Head of the Cardiology Department, Kemerovo Regional Clinical Hospital named after S.V. Belyaev.Oktyabrsky Ave., 22, Kemerovo, 650000.</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2906-6217</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мозес</surname><given-names>К. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Moses</surname><given-names>K. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мозес Кира Борисовна - ассистент кафедры поликлинической терапии и сестринского дела.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Moses Kira B. - a lecturer assistant at the Department of Outpatient Care and Nursing, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3269-9018</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мозес</surname><given-names>В. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Moses</surname><given-names>V. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мозес Вадим Гельевич - доктор медицинских наук, профессор кафедры акушерства и гинекологии им. Г.А. Ушаковой.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Moses Vadim G. - Ph.D., Professor at the Department of Obstetrics and Gynecology named G.A. Ushakova, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><email xlink:type="simple">vadimmoses@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6167-2968</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захаров</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharov</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захаров Игорь Сергеевич - доктор медицинских наук, заместитель главного врача государственного.пр. Октябрьский, 53/1, Кемерово, 650066.</p></bio><bio xml:lang="en"><p>Zakharov Igor S. - Ph.D., Deputy Medical Director of the Kemerovo Clinical Advisory and Diagnostic Center.53/1, Oktyabrsky Ave., Kemerovo, 650066.</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6966-2681</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Елгина</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Elgina</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елгина Светлана Ивановна - доктор медицинских наук, профессор кафедры акушерства и гинекологии им. Г.А. Ушаковой.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Elgina Svetlana I. - Ph.D., Professor at the Department of Obstetrics and Gynecology named G.A. Ushakova, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2948-9666</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Марцияш</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Marciyash</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марцияш Алексей Алексеевич - доктор медицинских наук, профессор кафедры неврологии, нейрохирургии, медицинской генетики и медицинской реабилитации.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Marciyash Alexey A. - Ph.D., Professor at the Department of Neurology, Neurosurgery, Medical Genetics, and Rehabilitation, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5526-2687</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Колпинский</surname><given-names>Г. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolpinskiy</surname><given-names>G. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Колпинский Глеб Иванович - доктор медицинских наук, профессор кафедры лучевой диагностики, лучевой терапии КемГМУ МЗ РФ; главный врач государственного, Клинический консультативно-диагностический центр.ул. Ворошилова, 22а, Кемерово, 650056; пр. Октябрьский, 53/1, Кемерово, 650066.</p></bio><bio xml:lang="en"><p>Kolpinskiy Gleb I. - Ph.D., Professor at the Department of Radiology Diagnosis and Therapy, Kemerovo State Medical University; Medical Director of the Kemerovo Clinical Advisory and Diagnostic Center.22a, Voroshilova St., Kemerovo, 650056; 53/1, Oktyabrsky Ave., Kemerovo, 650066.</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8938-3700</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шапкин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shapkin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шапкин Александр Анатольевич - кандидат медицинских наук, доцент кафедры факультетской хирургии.ул. Ворошилова, 22а, Кемерово, 650056.</p></bio><bio xml:lang="en"><p>Shapkin Alexander A. - Ph.D., Associate Professor at the Department of Surgery, Kemerovo State Medical University.22a, Voroshilova St., Kemerovo, 650056.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Кемеровский государственный медицинский университет Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Kemerovo State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Кузбасская клиническая больница имени С.В. Беляева<country>Россия</country></aff><aff xml:lang="en">Kemerovo Regional Clinical Hospital named after S.V. Belyaev<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Клинический консультативно-диагностический центр<country>Россия</country></aff><aff xml:lang="en">Kemerovo Clinical Advisory and Diagnostic Center<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">Кемеровский государственный медицинский университет Министерства здравоохранения Российской Федерации; Клинический консультативно-диагностический центр<country>Россия</country></aff><aff xml:lang="en">Kemerovo State Medical University; Kemerovo Clinical Advisory and Diagnostic Center<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>24</day><month>03</month><year>2021</year></pub-date><volume>10</volume><issue>1</issue><fpage>73</fpage><lpage>82</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Рудаева Е.В., Хмелева И.А., Мозес К.Б., Мозес В.Г., Захаров И.С., Елгина С.И., Марцияш А.А., Колпинский Г.И., Шапкин А.А., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Рудаева Е.В., Хмелева И.А., Мозес К.Б., Мозес В.Г., Захаров И.С., Елгина С.И., Марцияш А.А., Колпинский Г.И., Шапкин А.А.</copyright-holder><copyright-holder xml:lang="en">Rudaeva E.V., Khmeleva I.A., Moses K.B., Moses V.G., Zakharov I.S., Elgina S.I., Marciyash A.A., Kolpinskiy G.I., Shapkin A.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nii-kpssz.com/jour/article/view/818">https://www.nii-kpssz.com/jour/article/view/818</self-uri><abstract><p>В статье представлен аналитический обзор современных источников научной литературы, освещающих вопросы эпидемиологии, патогенеза и акушерской тактики при перипартальной кардиомиопатии (ПКМП). Данные о заболеваемости ПКМП крайне гетерогенны и зависят от географического региона. Смертность при данной патологии достигает 4-28%. К факторам риска развития ПКМП относятся многоплодная беременность и рождение нескольких детей, семейный анамнез, курение, сахарный диабет, артериальная гипертензия, преэклампсия, пониженное питание, старший или подростковый возраст матери и длительное лечение агонистами бета-адренорецепторов. В генезе заболевания ведущая роль отводится генетическому фактору, что подтверждается семейным анамнезом и изменением распространенности заболевания в зависимости от географического расположения. Описана патогенетическая роль вазоингибина - изоформы пролактина, обладающей мощным антиангиогенным, проапоптотическим, провоспалительным и вазоконстрикторным действием. Приведены данные, свидетельствующие о значимости нарушения соотношения ангио- и антиангиогенных факторов. В настоящее время отсутствуют общепринятые клинические рекомендации для акушеров-гинекологов по ведению беременных, рожениц и родильниц с ПКМП. Это обусловлено малым количеством накопленных данных о заболевании. При родоразрешении экстренное кесарево сечение показано в случае наличия у беременной острой сердечной недостаточности и потребности в инотропных лекарственных средствах и/или инвазивной терапии. В то же время, по мнению экспертов Европейского общества кардиологов (ESC, 2018), при отсутствии описанных выше состояний план родоразрешения может быть пересмотрен в сторону естественных родов.</p></abstract><trans-abstract xml:lang="en"><p>The article summarizes the current knowledge on epidemiology, pathophysiology, and management of patients with peripartum cardiomyopathy. The incidence of peripartum cardiomyopathy varies and largely depends on the geographic region. The overall mortality reaches up to 4-28%. Risk factors for developing peripartum cardiomyopathy include multiple pregnancies and multiple births, family history, smoking, diabetes mellitus, hypertension, preeclampsia, poor nutrition, older or adolescent maternal age, and long-term treatment with beta-adrenergic agonists. Genetic factors play the leading role in the pathophysiology of peripartum cardiomyopathy. It is generally confirmed by family history and the incidence variation depending on the geographical region. The pathogenetic role of vasoinhibin, an isoform of prolactin, is described. Vasoinhibin has antiangiogenic, proapoptotic, proinflammatory, and vasoconstrictor effects. The important role of an imbalance between angiogenic and antiangiogenic factors is discussed. There are no guidelines for obstetricians and gynecologists on the management of pregnant women, parturient women, and postpartum women. One of the reasons is the absence of evidence. An urgent cesarean section is indicated if the pregnant woman has acute heart failure and requires inotropic support and/or invasive therapy. However, 2018 ESC Guidelines for the Management of Cardiovascular Diseases during Pregnancy recommend vaginal delivery in these patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>Перипартальная кардиомиопатия</kwd><kwd>Беременность</kwd><kwd>Послеродовый период</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Peripartum cardiomyopathy</kwd><kwd>Pregnancy</kwd><kwd>Postpartum period</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Авторы заявляют об отсутствии финансирования исследования.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Pfeffer T.J., Hilfiker-Kleiner D. Pregnancy and heart disease: pregnancy-associated hypertension and peripartum cardiomyopathy. 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