DOI: https://doi.org/10.14739/2310-1210.2020.5.214754

Электрическая нестабильность миокарда как проблема современной терапевтической практики – реалии прогнозирования (обзор литературы)

V. P. Ivanov, Yu. Yu. Shushkovska, O. I. Afanasiuk, A. Ye. Danylchuk, S. M. Silina

Аннотация


 

Цель работы на основании данных научной литературы проанализировать последние научные исследования для возможности прогнозирования развития электрической нестабильности миокарда.

Материалы и методы. Проанализировать источники специализированной литературы, в которых отражены методы прогнозирования развития электрической нестабильности миокарда.

Результаты. Анализ научной литературы показывает, что электрическая нестабильность миокарда, в основе которой лежит ответ сердца при воздействии на него различных патогенных факторов, приводит к существенным изменениям электрофизиологических свойств сердечной мышцы, клинически проявляется нарушением ритма и проводимости и прогностически характеризуется разными степенями риска развития фатальных кардиальных событий.

Выводы. Неинвазивные методы оценки электрической нестабильности миокарда включают эхокардиографию, холтеровское мониторирование ЭКГ, определение показателей изменения деполяризации (феномен фрагментации QRS, поздние потенциалы желудочков), показатели изменения реполяризации (микровольтная альтернация зубца Т, дисперсия интервала QT), показатели автономной нервной системы (вариабельность и турбулентность сердечного ритма). Для определения аритмогенного субстрата можно проводить кардиальную магнитно-резонансную томографию. Маркеры фиброза дают возможность контролировать определение индивидуального риска развития электрической нестабильности миокарда. Методы прогнозирования и профилактики электрической нестабильности миокарда у больных гипертонической болезнью без ишемической болезни сердца и в сочетании с ней на основе изучения связи между наличием частой желудочковой экстрасистолии (электрической нестабильности миокарда) и плазменным уровнем биомаркеров фиброза (альдостерон, галектин-3 и трансформирующий фактор роста-β1) не выяснены в исследованиях.


 


Ключевые слова


электрическая нестабильность миокарда; желудочки сердца; аритмия

Полный текст:

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Литература


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