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<article 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" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">CardioSomatics</journal-id><journal-title-group><journal-title xml:lang="en">CardioSomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>CardioСоматика</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2221-7185</issn><issn publication-format="electronic">2658-5707</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">643236</article-id><article-id pub-id-type="doi">10.17816/CS643236</article-id><article-id pub-id-type="edn">RSHICA</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Key updates in clinical guidelines for the management of patients with chronic heart failure</article-title><trans-title-group xml:lang="ru"><trans-title>Ключевые изменения клинических рекомендаций по ведению пациентов с хронической сердечной недостаточностью</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7825-5597</contrib-id><contrib-id contrib-id-type="spin">3674-9620</contrib-id><name-alternatives><name xml:lang="en"><surname>Larina</surname><given-names>Vera N.</given-names></name><name xml:lang="ru"><surname>Ларина</surname><given-names>Вера Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>larinav@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0852-4349</contrib-id><contrib-id contrib-id-type="spin">3086-8592</contrib-id><name-alternatives><name xml:lang="en"><surname>Skiba</surname><given-names>Ivan K.</given-names></name><name xml:lang="ru"><surname>Скиба</surname><given-names>Иван Константинович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>skibaivan1@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8619-8123</contrib-id><contrib-id contrib-id-type="spin">6888-7050</contrib-id><name-alternatives><name xml:lang="en"><surname>Shcherbina</surname><given-names>Ekaterina S.</given-names></name><name xml:lang="ru"><surname>Щербина</surname><given-names>Екатерина Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>esscherbina@inbox.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-7328-5549</contrib-id><contrib-id contrib-id-type="spin">9578-9190</contrib-id><name-alternatives><name xml:lang="en"><surname>Lukin</surname><given-names>Andrei A.</given-names></name><name xml:lang="ru"><surname>Лукин</surname><given-names>Андрей Александрович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>geriatr_gp12@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">The Russian National Research Medical University named after N.I. Pirogov</institution></aff><aff><institution xml:lang="ru">Российский национальный исследовательский медицинский университет им. Н.И. Пирогова</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Diagnostic Clinical Center No. 1</institution></aff><aff><institution xml:lang="ru">Диагностический клинический центр № 1</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-10-22" publication-format="electronic"><day>22</day><month>10</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-12-09" publication-format="electronic"><day>09</day><month>12</month><year>2025</year></pub-date><volume>16</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>240</fpage><lpage>249</lpage><history><date date-type="received" iso-8601-date="2024-12-20"><day>20</day><month>12</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2025-06-22"><day>22</day><month>06</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, ООО "Эко-Вектор"</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">ООО "Эко-Вектор"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://cardiosomatics.ru/2221-7185/article/view/643236">https://cardiosomatics.ru/2221-7185/article/view/643236</self-uri><abstract xml:lang="en"><p>Chronic heart failure (CHF) is an increasingly important issue in the context of global population aging and advances in health care. This article analyzes key updates in the clinical guidelines of the European Society of Cardiology and the Russian Society of Cardiology for the management of patients with CHF, including revised classification and therapeutic approaches. A systematic search was conducted in PubMed, Google Scholar, and eLibrary.ru. The new classification emphasizes prevention of CHF rather than solely focusing on therapeutic strategies for established disease. The article discusses the roles of sodium–glucose cotransporter 2 inhibitors, angiotensin receptor–neprilysin inhibitors, and highlights the novel mineralocorticoid receptor antagonist finerenone. A synthesis of recent studies and expert opinions provides clinicians with current evidence-based knowledge on the management of CHF. The most important aspect of the updated recommendations is the preventive approach aimed at reducing CHF incidence. These data may be useful for primary care physicians, hospital-based clinicians, and clinical researchers, contributing to improved quality and outcomes of patient care.</p></abstract><trans-abstract xml:lang="ru"><p>Хроническая сердечная недостаточность (ХСН) становится всё более актуальной проблемой в контексте глобального старения населения и определённых достижений системы здравоохранения. В статье анализируются ключевые изменения клинических рекомендаций Европейского общества кардиологов и Российского кардиологического общества по ведению пациентов с ХСН, включая обновлённую классификацию и терапевтические подходы. Поиск литературных источников проведён в электронных базах данных Pubmed, Google Scholar, eLibrary.ru. Новая классификация направлена на улучшение профилактики ХСН, а не только на корректный выбор тактики терапии существующего заболевания. Обсуждается роль ингибиторов натрий-глюкозного котранспортёра 2-го типа, ангиотензиновых рецепторов и неприлизина ингибиторов, а также освещается место нового антагониста минералкортикоидных рецепторов — финеренона. Обобщение последних исследований и экспертного опыта обеспечивает специалистов современными знаниями о лечении ХСН. Однако наиболее важный аспект обновлённых рекомендаций — превентивный подход, направленный на предотвращение развития ХСН. Актуальные данные могут быть полезны как для врачей первичного звена, так и для врачей, оказывающих медицинскую помощь в условиях стационара, врачей-исследователей и позволят повысить качество и улучшить результаты лечения пациентов.</p></trans-abstract><kwd-group xml:lang="en"><kwd>heart failure</kwd><kwd>classification</kwd><kwd>finerenone</kwd><kwd>quadruple therapy</kwd><kwd>clinical guidelines</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>хроническая сердечная недостаточность</kwd><kwd>классификация</kwd><kwd>финеренон</kwd><kwd>квадротерапия</kwd><kwd>клинические рекомендации</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>James SL, Abate D, Abate KH. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. 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