Реперфузионное повреждение сердца. Роль микроваскулярной обструкции

Реперфузионное повреждение сердца. Роль микроваскулярной обструкции

Автор: Рябов В. В., Попов С. В., Вышлов Е. В., Сиротина М., Нарыжная Н. В., Мухомедзянов А. В., Деркачев И. А., Курбатов Б. К., Гомбожапова А. Е., Диль С. В., Самойлова Ю. О., Суфианова Г. З., Хлсткина М. С., Маслов Л. Н.

Журнал: Сибирский журнал клинической и экспериментальной медицины @cardiotomsk

Рубрика: Обзоры и лекции

Статья в выпуске: 2 т.38, 2023 года.

Бесплатный доступ

Микроваскулярная обструкция (МВО) коронарных артерий способствует увеличению смертности и неблагоприятных сердечно-сосудистых событий у пациентов с острым инфарктом миокарда (ОИМ) и чрескожным коронарным вмешательством (ЧКВ). Были получены предварительные данные, свидетельствующие о том, что в патогенез МВО могут быть вовлечены тромбоциты, воспаление, Са2+-перегрузка, нейропептид Y и эндотелин-1. Многие вопросы, связанные с патогенезом МВО, остаются без ответа. Неизвестна роль повреждения эндотелиальных клеток в формировании МВО у пациентов с ОИМ и ЧКВ. Неясно, снижается ли продукция оксида азота (NO), или же снижается чувствительность гладкомышечных клеток коронарных артерий к NO у пациентов с МВО. Получены лишь косвенные данные об участии воспаления в развитии МВО. Роль активных форм кислорода в патогенезе МВО не изучена. Роль некроптоза и пироптоза в патогенезе МВО у больных с ОИМ и ЧКВ также не изучена. Значение тромбоксана А, вазопрессина, ангиотензина II и простациклина в формировании МВО до сих пор неизвестно. Не было получено убедительных данных об участии спазма коронарных артерий в развитии МВО. Не проводился корреляционный анализ уровней нейропептида Y, эндотелина-1 и размера МВО у больных с ОИМ и ЧКВ. Неясно, усугубляет ли эндогенный адреналин МВО или, напротив, предупреждает МВО.

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Сердце, ишемия, реперфузия, микроваскулярная обструкция, no-reflow

Короткий адрес: https://sciup.org/149142828

IDR: 149142828   |   DOI: 10.29001/2073-8552-2023-39-2-14-22

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