russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2018-1-83-88russjcardiol-2635Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWПСИХОСОМАТИЧЕСКИЙ ПОРОЧНЫЙ КРУГ ИНФАРКТА МИОКАРДАA PSYCHOSOMATIC VICIOUS CIRCLE OF MYOCARDIAL INFARCTIONhttps://orcid.org/0000-0003-2925-0102ТаратухинЕ. О.TaratukhinE. О.

Таратухин Евгений Олегович — кандидат медицинских наук, магистр психологии, доцент кафедры госпитальной терапии № 1 л/ф, SPIN-код: 9566-9557.

Москва

Moscow

cardio03@list.ruГордеевИ. Г.GordeevI. G.

Гордеев И. Г. — Доктор медицинских наук, профессор, заведующий кафедрой.

Москва

Moscow

ЛебедеваА. Ю.LebedevaA. Yu.

Лебедева А. Ю. — Доктор медицинских наук, профессор кафедры.

Moscow

ФГБОУ ВО Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical University (RNRMU)Russian Federation201808032018018388Copyright © Таратухин Е.О., Гордеев И.Г., Лебедева А.Ю., 20182018Таратухин Е.О., Гордеев И.Г., Лебедева А.Ю.Taratukhin E.О., Gordeev I.G., Lebedeva A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/2635

Представлен обзор исследований, демонстрирующих соматические изменения при психологических процессах, принятых как факторы риска острого инфаркта миокарда: депрессия, стресс, тревога. На основании метафорического обозначения “идеальный шторм” показаны воспалительные, иммунологические, нейрогуморальные предпосылки развития инфаркта миокарда, а равно таковые изменения, являющиеся соматическим субстратом психологических состояний, способствующих развитию инфаркта миокарда посредством поведенческих и биологических факторов риска: “болезненное поведение”, “депрессионная болезнь”. Два эти процесса входят в психосоматический “порочный круг”. В статье делается акцент на важности индивидуализации подхода к реабилитации и вторичной профилактике инфаркта миокарда, поскольку с биопсихосоциальной точки зрения восходящие и нисходящие психосоматические связи у каждого пациента уникальны.

The review presents recent studies demonstrating somatic shifts in psychological processes regarded as the risk factors for myocardial infarction: depression, stress, anxiety. Based upon a metaphorical term “a perfect storm”, inflammatory, immunological, neuro-humoral predisposing factors are presented, important for myocardial infarction development, as such shifts themselves, which are the somatic substrate for psychological states mediating myocardial infarction development through behavioral and biological risk factors: “sickness behavior”, “depression illness”. Both directions complete a vicious circle of psychosomatic changes. The emphasis is set on the importance of individual approach to rehabilitation and secondary prevention of myocardial infarction, as, from biopsychosocial point of view, the bottom-up and top-down psychosomatic links are unique for any patient.

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The authors declare that there are no conflicts of interest present.