Повреждение миокарда после внесердечных операций: современное состояние проблемы и нерешенные вопросы
https://doi.org/10.15829/1560-4071-2019-11-122-132
Аннотация
В обзоре на основе данных литературы последнего десятилетия, рекомендаций международных и национальных профессиональных сообществ обобщены сведения о повреждении миокарда после внесердечных хирургических операций (ПМВО). Отражен растущий интерес к этой междисциплинарной проблеме, вызванный широкой распространенностью и тесной ассоциацией ПМВО со смертностью в послеоперационном периоде. Проанализированы наблюдательные исследования, посвященные поиску факторов риска и механизмов повреждения миокарда при хирургическом вмешательстве на других органах. Сделан акцент на роли бессимптомного повышения сердечных тропонинов, не уступающего по своей клинической и прогностической значимости послеоперационному инфаркту миокарда. Изложены современные подходы к диагностике и профилактике ПМВО. С учетом результатов недавно завершившегося первого рандомизированного контролируемого исследования MANAGE (2018) обсуждены возможности и перспективы лечения ПМВО. Определены нерешенные вопросы и направления дальнейших исследований в этой области.
Об авторах
К. В. Протасов
Иркутская государственная медицинская академия последипломного образования — филиал ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава России
Россия
Россия
Протасов Константин Викторович — доктор медицинских наук профессор, заведующий кафедрой кардиологии и функциональной диагностики.
Иркутск.
SPIN-код 7898-9690
О. А. Большедворская
Областной онкологический диспансер
Россия
Россия
Большедворская Ольга Александровна — врач-терапевт торакального отделения.
Иркутск.
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Рецензия
Для цитирования:
Протасов К.В., Большедворская О.А. Повреждение миокарда после внесердечных операций: современное состояние проблемы и нерешенные вопросы. Российский кардиологический журнал. 2019;(11):122-132. https://doi.org/10.15829/1560-4071-2019-11-122-132
For citation:
Protasov K., Bolshedvorskaya O. Myocardial injury after non-cardiac surgery: current state of the problem and unresolved issues. Russian Journal of Cardiology. 2019;(11):122-132. (In Russ.) https://doi.org/10.15829/1560-4071-2019-11-122-132
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