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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">cardiotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский журнал клинической и экспериментальной медицины</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian Journal of Clinical and Experimental Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2713-2927</issn><issn pub-type="epub">2713-265X</issn><publisher><publisher-name>TSU publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.29001/2073-8552-2024-39-4-10-17</article-id><article-id custom-type="elpub" pub-id-type="custom">cardiotomsk-2256</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ И ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS AND LECTURES</subject></subj-group></article-categories><title-group><article-title>Функциональная значимость стенозов коронарных артерий: роль артериальной гипертонии (обзор литературы)</article-title><trans-title-group xml:lang="en"><trans-title>Functional significance of coronary artery stenosis: the role of arterial hypertension (literature review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2238-4573</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мордовин</surname><given-names>В. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Mordovin</surname><given-names>V. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мордовин Виктор Федорович, д-р мед. наук, профессор, ведущий научный сотрудник, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Victor F. Mordovin, Dr. Sci. (Med.), Professor, Leading Research Scientist, Department of Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">mordovin@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4066-869X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Личикаки</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lichikaki</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Личикаки Валерия Анатольевна, канд. мед. наук, научный сотрудник, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Valeria A. Lichikaki, Cand. Sci. (Med.), Research Scientist, Department of Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">manankovalera@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4008-4021</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пекарский</surname><given-names>С. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Pekarsky</surname><given-names>S. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пекарский Станислав Евгеньевич, д-р мед. наук, ведущий научный сотрудник, лаборатория рентгенэндоваскулярной хирургии, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Stanislav E. Pekarsky, Dr. Sci. (Med.), Leading Research Scientist, Laboratory of X-ray Endovascular Surgery,</p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">Pekarski@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6995-9875</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зюбанова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zyubanova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зюбанова Ирина Владимировна, канд. мед. наук, научный сотрудник, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Irina V. Zyubanova, Cand. Sci. (Med.), Research Scientist, Department of Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">ziv@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3577-1895</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Манукян</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Manukyan</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Манукян Мушег Айкович, канд. мед. наук, научный сотрудник, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Musheg A. Manukyan, Cand. Sci. (Med.), Research Scientist, Department of Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">manukyan.muscheg@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9857-4368</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солонская</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Solonskaya</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солонская Екатерина Игоревна, канд. мед. наук, младший научный сотрудник, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Ekaterina I. Solonskaya, Cand. Sci. (Med.), Junior Research Scientist, Department of Hypertension,</p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">haksen_sgmu@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1192-0489</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Popova</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Попова Анастасия Анатольевна, аспирант, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Anastasiya A. Popova, Graduate Student, Department of Arterial Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">vaa@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5000-4216</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хунхинова</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Khunkhinova</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хунхинова Симжит Андреевна, аспирант, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Simzhit A. Khunkhinova, Graduate Student, Department of Hypertension,</p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">hsa@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5954-1640</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скомкина</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Skomkina</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Скомкина Ирина Александровна, ординатор, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Irina A. Skomkina, Medical Assistant, Department of Arterial Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">sia@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-3340-0556</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солтанахметова</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Soltanakhmetova</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солтанахметова Айгерим Досжановна, ординатор, отделение артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Aigerim D. Soltanakhmetova, Medical Resident, Department of Arterial Hypertension,</p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">sad@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5638-3034</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фальковская</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Falkovskaya</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фальковская Алла Юрьевна, д-р мед. наук, заведующий отделением артериальных гипертоний, </p><p>634012, Томск, ул. Киевская, 111а</p></bio><bio xml:lang="en"><p>Allа Yu. Falkovskaya, Dr. Sci. (Med.), Head of Department of Hypertension, </p><p>111a, Kievskaya str., Tomsk, 634012</p></bio><email xlink:type="simple">alla@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук (НИИ кардиологии, Томский НИМЦ)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2024</year></pub-date><volume>39</volume><issue>4</issue><issue-title>Выпуск 2024_4</issue-title><fpage>10</fpage><lpage>17</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мордовин В.Ф., Личикаки В.А., Пекарский С.Е., Зюбанова И.В., Манукян М.А., Солонская Е.И., Попова А.А., Хунхинова С.А., Скомкина И.А., Солтанахметова А.Д., Фальковская А.Ю., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Мордовин В.Ф., Личикаки В.А., Пекарский С.Е., Зюбанова И.В., Манукян М.А., Солонская Е.И., Попова А.А., Хунхинова С.А., Скомкина И.А., Солтанахметова А.Д., Фальковская А.Ю.</copyright-holder><copyright-holder xml:lang="en">Mordovin V.F., Lichikaki V.A., Pekarsky S.E., Zyubanova I.V., Manukyan M.A., Solonskaya E.I., Popova A.A., Khunkhinova S.A., Skomkina I.A., Soltanakhmetova A.D., Falkovskaya A.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.sibjcem.ru/jour/article/view/2256">https://www.sibjcem.ru/jour/article/view/2256</self-uri><abstract><p>Артериальная гипертония (АГ) в настоящее время рассматривается как основной фактор риска развития обструктивных и необструктивных форм атеросклероза эпикардиальных артерий. Представленные данные свидетельствуют о многогранном влиянии этой патологии не только на структурные, но и на функциональные изменения венечных сосудов, в том числе и на уровне микроциркуляции. Коронарная микрососудистая дисфункция (КМД) гипертензивного генеза оказывает существенное влияние на функциональную значимость стенозов магистральных коронарных артерий по данным измерения фракционного коронарного резерва. Этому показателю в настоящее время придается существенное значение при определении тактики лечения пациентов с обструктивными формами ишемической болезни сердца (ИБС). Следует, однако, отметить, что данные об их значении при проведении выбора между оптимальной медикаментозной терапией и эндоваскулярными вмешательствами пока неоднозначны. В связи с этим, дополнительный учет влияния АГ и КМД, может позволить более обоснованно выбирать тактику лечения. Не менее важно учитывать, самостоятельное неблагоприятное прогностическое значение КМД. Это обуславливает актуальность разработки новых методов таргетного лечения, снижающих степень выраженности этих нарушений, однако эти вопросы, пока нуждаются в проведении дальнейших исследований. Кроме того, уровни артериального давления влияют на развитие коллатерального кровообращения, позволяющего сохранять перфузию миокарда в бассейне стенозированных артерий. Учет этих факторов в перспективе позволит улучшить результаты лечения у пациентов с тяжелыми формами ИБС и обструктивными изменениями эпикардиальных артерий.</p></abstract><trans-abstract xml:lang="en"><p>Arterial hypertension (AH) is currently considered as the main risk factor for the development of atherosclerosis of the epicardial arteries, contributing to the formation of not only structural, but also functional changes in the coronary vessels, including at the level of microcirculation.</p><p>Aim: To assess the influence of coronary microvascular dysfunction (CMD) of hypertensive origin on the functional significance of stenoses of the main coronary arteries according to measurements of fractional flow reserve (FFR), as well as to analyze the mechanisms of CMD formation in patients with coronary heart disease in combination with hypertension. The FFR measurement method is considered as a standard for making decisions about myocardial revascularization, which can increase the effectiveness of the intervention. However, the results available to date are still ambiguous, as evidenced by the results of numerous meta-analyses presented in the work. Equally important is the assessment of the independent unfavorable prognostic value of CMD, which makes it urgent to develop new targeted treatment methods that reduce the severity of these disorders.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>артериальная гипертония</kwd><kwd>сердечно-сосудистый риск</kwd><kwd>ишемическая болезнь сердца</kwd><kwd>фракционный коронарный резерв</kwd><kwd>коронарная микрососудистая дисфункция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>arterial hypertension</kwd><kwd>cardiovascular risk</kwd><kwd>cardiac ischemia</kwd><kwd>fractional coronary reserve</kwd><kwd>coronary microvascular dysfunction</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Першина Е.С., Синицын В.Е., Мершина Е.А., Архипова И.М., Семитко С.П., Иванов В.А. 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