Внезапная сердечная смерть у больных гипертрофической кардиомиопатией

DOI: https://dx.doi.org/10.18565/cardio.2016.1.56-65

Ватутин Н.Т., Тарадин Г.Г., Марон М.С., Шевелек А.Н.

1Донецкий национальный медицинский университет им. М. Горького, Донецк, Украина; 2Tuft University School of Medicine, Hypertrophic Cardiomyopathy Center, Tufts Medical Center, Boston, Massachusetts, USA
Обзор литературы посвящен вопросам изучения внезапной сердечной смерти (ВСС) при гипертрофической кардиомиопатии (ГКМП), рассматриваются вопросы распространенности ВСС и ее структуры среди молодых лиц и тренированных спортсменов. Обсуждается связь ВСС с полом, возрастом и гипертрофическим ответом миокарда на физическую нагрузку. Подробно представлены современные взгляды на аритмогенный субстрат, лежащий в основе ВСС при ГКМП, а также патофизиологический каскад опасных для жизни желудочковых тахиаритмий. Подробно освещены подходы к выявлению лиц, находящихся в группе высокого риска ВСС, а также перечислены основные и дополнительные клинические критерии, обсуждаемые с точки зрения факторов прогнозирования риска неблагоприятного исхода. Подробно приведены результаты крупных исследований, оценивающих роль имплантируемых кардиовертеров-дефибрилляторов для первичной и вторичной профилактики ВСС у больных ГКМП. Даны клинические рекомендации по целесообразности их установки с учетом анализа суммарной эффективности и количества осложнений.
Ключевые слова: аритмогенный субстрат, имплантируемый кардиовертер-дефибриллятор, внезапная сердечная смерть, гипертрофическая кардиомиопатия, стратификация риска, эпидемиология
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Об авторах / Для корреспонденции

Донецкий национальный медицинский университет им. М. Горького, Донецк, Украина
Кафедра внутренней медицины №1
Ватутин Н.Т. - д.м.н., проф., зав. кафедрой.
Тарадин Г.Г. - к.м.н., доцент кафедры.
Шевелек А.Н. - к.м.н., доцент кафедры.
Tuft University School of Medicine, Hypertrophic Cardiomyopathy Center, Tufts Medical Center, Boston, Massachusetts, USA
Марон М.С. - д.м.н., директор Центра гипертрофической кардиомиопатии.
E-mail: taradin@inbox.ru


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