cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2024-39-4-26-37cardiotomsk-2033Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESФизиология детского сердца и патогенетические механизмы, оказывающие влияние на процесс роста и развития сердечно-сосудистой системы у рожденных преждевременно: современный взгляд на проблемуPediatric heart physiology and pathogenetic mechanisms affecting the process of growth and development of the cardiovascular system premature infants: a modern view at the problemhttps://orcid.org/0000-0002-3081-9477ПавлюковаЕ. Н.PavlyukovaE. N.

Павлюкова Елена Николаевна, д-р мед. наук, профессор, заведующий отделением атеросклероза и хронической ишемической болезни сердца, 

634012, Томск, ул. Киевская, 111а

Elena N. Pavlyukova, Dr. Sci. (Med.), Professor, Head of the Department of Atherosclerosis and Chronic Coronary Heart Disease,

111a, Kievskaya str., Tomsk, 634012

pavlyukovaelena@yandex.ruhttps://orcid.org/0000-0002-5550-5925КолосоваМ. В.KolosovaM. V.

Колосова Марина Владимировна, д-р мед. наук, профессор, кафедра педиатрии с курсом эндокринологии, 

634050, Томск, Московский тракт, 2

Marina V. Kolosova, Dr. Sci. (Med.), Professor, Department of Children’s Diseases, 

2, Moskovskiy tract, Tomsk, 634050

kolosova_mv@inbox.ruhttps://orcid.org/0000-0002-7556-9379НеклюдоваГ. В.NeklyudovaG. V.

Неклюдова Галина Владимировна, аспирант, 

634012, Томск, ул. Киевская, 111а

Galina V. Neklyudova, Graduate Student, 

111a, Kievskaya str., Tomsk, 634012

lv-gal@mail.ruhttps://orcid.org/0000-0003-0335-9126АлексееваЕ. О.AlekseevaE. O.

Алексеева Евгения Олеговна, аспирант, 

634012, Томск, ул. Киевская, 111а

Evgeniya O. Alekseeva, Graduate Student,

111a, Kievskaya str., Tomsk, 634012

alexeeva_777@mail.ruhttps://orcid.org/0000-0002-7011-4316КарповР. С.KarpovR. S.

Карпов Ростислав Сергеевич, д-р мед. наук, академик РАН, научный руководитель,

634012, Томск, ул. Киевская, 111а

Rostislav S. Karpov, Dr. Sci. (Med.), Academician of the Russian Academy of Sciences, Scientific Supervisor, 

111a, Kievskaya str., Tomsk, 634012

karpov@cardio-tomsk.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук (НИИ кардиологии, Томский НИМЦ)РоссияCardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences (Cardiology Research Institute, Tomsk NRMC)Russian FederationСибирский государственный медицинский университет Министерства здравоохранения Российской Федерации (СибГМУ Минздрава России)РоссияSiberian State Medical University of the Ministry of Health of the Russian Federation (SSMU)Russian Federation202405122024394Выпуск 2024_42637Copyright © Павлюкова Е.Н., Колосова М.В., Неклюдова Г.В., Алексеева Е.О., Карпов Р.С., 20252025Павлюкова Е.Н., Колосова М.В., Неклюдова Г.В., Алексеева Е.О., Карпов Р.С.Pavlyukova E.N., Kolosova M.V., Neklyudova G.V., Alekseeva E.O., Karpov R.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2033

Цель представленного аналитического обзора: изучение состояния тканевого гомеостаза сердца в процессе онтогенеза в условиях недоношенности в свете современных фундаментальных знаний по биологии стволовых клеток сердца, строению кардиомиоцитов, паракринным механизмам регуляции и другим патогенетическим механизмам, влияющим на рост, развитие и ремоделирование сердечно-сосудистой системы в детском возрасте и в отдаленной перспективе.

Стратегия поиска литературы. Поиск исследований и аналитических обзоров литературы проведен в базах данных Cochrane library, MEDLINE, Академия Google, PubMed и других базах в основном за период с января 2018 до декабря 2023 гг. Для включения независимым образом отбирались публикации / исследования, отражающие различные аспекты физиологии детского сердца у рожденных преждевременно (клинические и экспериментальные аспекты). Предпочтение отдавалось рандомизированным контролируемым исследованиям.

Результаты

Результаты. На основании современных представлений о до- и постимплантационном (постнатальном) развитии и росте детского сердца дан анализ процессам постнатального роста и развития сердца детей, рожденных здоровыми доношенными и недоношенными при спонтанном естественном зачатии. Проведен анализ основных патогенетических механизмов, влияющих на рост и развитие детского сердца во внутриутробный и постнатальный период.

Заключение

Заключение. Экспериментальные и клинические данные обоснованно требуют осознанной ревизии фундаментальных теоретических постулатов о регенеративных возможностях миокарда в различные периоды детского возраста, включая клиническую группу рожденных недоношенными, и практических установок по ведению беременности при угрозе прерывания и бесплодии (мероприятия в доимплантационный период при использовании вспомогательных репродуктивных технологий), по проводимой комбинированной / интенсивной (в том числе респираторной) терапии в неонатальный период, по длительному наблюдению в амбулаторных условиях за рожденными преждевременно с низкой, очень низкой и экстремально низкой массой тела детьми и взрослыми с целью профилактики, скрининга и лечения потенциальных последствий для здоровья сердечно-сосудистой системы на протяжении всей жизни.

Aim

Aim: To study the state of cardiac tissue homeostasis in the process of ontogenesis in prematurity in the light of modern fundamental knowledge on the biology of cardiac stem cells, the structure of cardiomyocytes, paracrine regulation mechanisms and other pathogenetic mechanisms affecting the growth, development and remodeling of the cardiovascular system in childhood and in follow-up.

Literature search strategy. A search for studies and analytical literature reviews was conducted in databases Cochrane library, MEDLINE, Google Academy, PubMed and other databases mainly from the beginning of 2018 to December 2023. Publications/ studies reflecting various aspects of the physiology of the infant heart in premature infants (clinical and experimental aspects) were independently selected for inclusion. Preference was given to randomized controlled trials.

Results

Results. Based on modern concepts of pre- and post-implantation (postnatal) development and growth of the infant heart, the analysis of the processes of postnatal growth and development of the heart of children born healthy full-term and premature with spontaneous natural conception is given. The analysis of the main pathogenetic mechanisms influencing the processes of growth and development of the child’s heart in the intrauterine and postnatal period is carried out.

Conclusion

Conclusion. Experimental and clinical data reasonably require a conscious revision of the fundamental theoretical postulates about the regenerative capabilities of the myocardium in various periods of childhood, including the clinical group of premature babies, and practical guidelines for pregnancy management with the threat of abortion and infertility (preimplantation measures using assisted reproductive technologies), combined/intensive (including, respiratory) therapy in the neonatal period, longterm outpatient follow-up of children and adults born prematurely with low, very low and extremely low body weight in order to prevent, screen and treat potential effects on the health of the cardiovascular system throughout life. The information provided is very useful for a wide range of readers – biologists, embryologists, reproductive doctors, obstetricians, gynecologists, neonatologists, pediatricians, internists, cardiologists, surgeons.

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