O‘tkir miokard infarkti bo‘lgan bemorlarda miokard revascularizatsiyasining neyrogormonal va gemodinamik ko‘rsatkichlarga ta’siri
Annotatsiya
Kirish. O‘tkir miokard infarkti (OMI) butun dunyo bo‘ylab kasallanish va o‘limning asosiy sabablaridan biri bo‘lib qolmoqda. OMI bo‘lgan bemorlarda miokard revascularizatsiyasining neyrogormonal darajalar va gemodinamik ko‘rsatkichlarga ta’siri klinik tibbiyotda muhim tadqiqot mavzusi hisoblanadi.
Materiallar va usullar. Tadqiqotda ST-segment ko‘tarilishi bilan kechuvchi o‘tkir koronar sindrom (ACSspST) tashxisi qo‘yilgan 120 nafar bemor ishtirok etdi, ularning o‘rtacha yoshi 52,9±8,9 yilni tashkil etdi. Bemorlar ikki guruhga bo‘lindi: I-guruh (89 bemor) – revascularizatsiya o‘tkazilmagan, II-guruh (31 bemor) – perkutan koronar intervensiya (PKI) va stentlash o‘tkazilgan. Tadqiqot davomida neyrogormonal markerlar NTproBNP va eruvchan ST2, shuningdek, exokardiyografik ko‘rsatkichlar kasalxonaga yotqizilganidan keyin 10-14-kunlarda baholandi.
Natijalar. Neyrogormonal darajalar tahlili NTproBNP darajasida guruhlar orasida sezilarli farq aniqlanmaganligini ko‘rsatdi, ammo PKI guruhi bilan solishtirilganda, revascularizatsiya o‘tkazilmagan guruhda NTproBNP darajalari yuqoriroq bo‘ldi. Aksincha, ST2 darajasi PKI guruhida (130,8±48,6 ng/ml) revascularizatsiya o‘tkazilmagan guruhga (196,8±58,2 ng/ml) nisbatan sezilarli darajada pastroq ekanligi aniqlandi (p<0,05). Gemodinamik ko‘rsatkichlar, jumladan chap qorinchaning diastolik (EDV) va sistolik (ESV) yakuniy hajmlari PKI guruhida ancha pastroq bo‘ldi.
Xulosa. Miokard revascularizatsiyasi, ayniqsa koronar stentlash, neyrogormonal markerlarning, xususan eruvchan ST2 darajasining yaxshilanishiga hamda gemodinamik ko‘rsatkichlarning ijobiy o‘zgarishiga sezilarli ta’sir ko‘rsatdi. Bu esa PKI o‘tkazilgan bemorlarda klinik natijalarning yaxshiroq ekanligini ko‘rsatadi.
Kalit so‘zlar:
Mualliflar haqida
Adabiyotlar ro'yxati
Kovalev S.A., Malikov V.E., Effectiveness of pharmacotherapy in normalizing the level of brain natriuretic peptide and activity of the renin-angiotensin-aldosterone system after myocardial revascularization in patients with post-infarction cardiosclerosis, Cardiovascular Therapy and Prevention, 2016, 15, 06, 39-45, 10.15829/1728-8800-2016-6-39-45.
Osipova O.A., Nagibina A.I., Komisov A.A., Pathomorphological mechanisms of myocardial fibrosis regulation in patients with chronic heart failure against the background of ischemic heart disease, Heart Failure, 2019, 17, 05, 357-364, https://www.rmj.ru/articles/kardiologiya/.
Revishvili A.Sh., Golitsyn S.P., Egorov D.F., Russian Clinical Guidelines for the Control of Sudden Cardiac Arrest and Sudden Cardiac Death, Prevention and First Aid, Bulletin of Arrhythmology, 2017, 89, 2-104, https://vestar.elpub.ru/jour/article/view/77.
Uskov V.M., Modeling, Algorithmization, and Forecasting of Outcomes in Transmural Myocardial Infarction with Various Medication Schemes: Author’s Abstract for Medical Sciences Dissertation, Voronezh State Technical University, , 2004, https://www.dissercat.com/content/modelirovanie- algoritmizatsiya-i-prognozirovanie-iskhodov-transmuralnogo-infarkta-miokarda.
Fomin I.V., Chronic Heart Failure in the Russian Federation: What We Know Today and What We Should Do, Russian Cardiological Journal, 2016, 8, 0136, 7-13, 10.15829/1560-4071-2016-8-7-13.
Bouisset F., Gerbaud E., Bataille V., Coste P., Puymirat E., Belle L., Percutaneous Myocardial Revascularization in Late-Presenting Patients with STEMI, Journal of the American College of Cardiology, 2021, 78, 1291-1305, 10.1016/j.jacc.2021.07.039.
Chackerian A.A., Oldham E.R., Murphy E.E., Schmitz J., Pflanz S., Kastelein R.A., IL-1 Receptor Accessory Protein and ST2 Comprise the IL-33 Receptor Complex, Journal of Immunology, 2007, 179, 04, 2551-2555, 10.4049/jimmunol.179.4.2551.
Ciccone M.M., Cortese F., Gesualdo M., Riccardi R., Di Nunzio D., Moncelli M., Iacoviello M., Scicchitano P.A., Novel Cardiac Biomarker: ST2: A Review, Molecules, 2013, 18, 15314-15328, 10.3390/molecules181215314.
Felker G.M., Fiuzat M., Thompson V., Shaw L.K., Neely M.L., Adams K.F., Whellan D.J., Donahue M.P., Ahmad T., Kitzman D.W., Pina I.L., Zannad F., Kraus W.E., O’Connor C.M., Soluble ST2 in Ambulatory Patients with Heart Failure: Association with Functional Capacity and Long-Term Outcomes, Circulation: Heart Failure, 2013, 6, 1172-1179, 10.1161/CIRCHEARTFAILURE.113.000207.
Go A.S., Mozaffarian D., Roger V.L., Heart Disease and Stroke Statistics-2014 Update: A Report from the American Heart Association, Circulation, 2014, 129, 03, 280-292, 10.1161/01.cir.0000441139.02102.80.
Gravning J., Smedsrud M.K., Omland T., Eek C., Skulstad H., Aaberge L., Bendz B., Kjekshus J., Morkrid L., Edvardsen T., Sensitive Troponin Assays and N-Terminal Pro-B-Type Natriuretic Peptide in Acute Coronary Syndrome: Prediction of Significant Coronary Lesions and Long-Term Prognosis, American Heart Journal, 2013, 165, 05, 716-724, 10.1016/j.ahj.2013.02.008.
Mosterd A., Hoes A.W., Clinical Epidemiology of Heart Failure, Heart, 2007, 93, 1137-1146, 10.1161/01.cir.0000441139.02102.80.
Maries L., Manitiu I., Diagnostic and Prognostic Values of B-Type Natriuretic Peptides (BNP) and N-terminal Fragment Brain Natriuretic Peptides (NT-pro-BNP), Cardiovascular Journal of Africa, 2013, 24, 07, 286-289, 10.5830/cvja-2013-055.
Menon V., Pearte C.A., Buller C.E., Steg Ph.G., Forman S.A., White H.D., Lack of Benefit from Percutaneous Intervention of Persistently Occluded Infarct Arteries after the Acute Phase of Myocardial Infarction is Time Independent: Insights from Occluded Artery Trial, European Heart Journal, 2009, 30, 183-191, 10.1093/eurheartj/ehn486.
Nichols M., Townsend N., Scarborough P., Rayner M., Cardiovascular Disease in Europe 2014: Epidemiological Update, European Heart Journal, 2014, 35, 042, 2950-2959, 10.1093/eurheartj/ehu299.
Scho¨mig A., Mehilli J., Antoniucci D., Ndrepepa G., Markwardt C., Di Pede F., Mechanical Reperfusion in Patients with Acute Myocardial Infarction Presenting More Than 12 Hours from Symptom Onset: A Randomized Controlled Trial, JAMA, 2005, 293, 2865-2872, 10.1001/jama.293.23.2865.
Steg P.G., Dabbous O.H., Feldman L.J., Determinants and Prognostic Impact of Heart Failure Complicating Acute Coronary Syndromes: Observations from the Global Registry of Acute Coronary Events (GRACE), Circulation, 2004, 109, 494-499, 10.1161/01.cir.0000109691.16944.da.
Ndrepepa G., Kastrati A., Mehilli J., Antoniucci D., Scho¨mig A., Mechanical Reperfusion and Long-Term Mortality in Patients with Acute Myocardial Infarction Presenting 12 to 48 Hours from Onset of Symptoms, JAMA, 2009, 301, 487-488, 10.1001/jama.2009.32.

Ushbu asar saytida mavjud litsenziyalar Creative Commons «Attribution-NonCommercial-ShareAlike» («Atribut - notijorat maqsadlarda foydalanish - bir xil shartlar») 4.0 Всемирная.