cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2018-33-4-10-18cardiotomsk-606Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEИНФАРКТ МИОКАРДА БЕЗ ОБСТРУКТИВНОГО КОРОНАРНОГО АТЕРОСКЛЕРОЗА — АКТУАЛЬНАЯ ПРОБЛЕМА НЕОТЛОЖНОЙ КАРДИОЛОГИИMYOCARDIAL INFARCTION WITH NONOBSTRUCTIVE CORONARY ATHEROSCLEROSIS AS A CURRENT PROBLEM OF EMERGENCY CARDIOLOGYРябовВ. В.RyabovV. V.

д-р мед. наук, руководитель отделения неотложной кардиологии, ведущий научный сотрудник лаборатории трансляционной клеточной и молекулярной биомедицины, профессор кафедры кардиологии ФПК и ППС  

634012, Российская Федерация, Томск, ул. Киевская, 111а

634050, Российская Федерация, Томск, Московский тракт, 2

634050, Российская Федерация, Томск, пр. Ленина, 36

Dr. Sci. (Med.), Head of the Department of Emergency Cardiology, 

Leading Research Fellow of the Laboratory for TranslationalCell and Molecular Biomedicine, 

Professor of Cardiology Department

111a, Kievskaya str., Tomsk, 634012, Russian Federation

2, Moskovsky tract, Tomsk, 634050, Russian Federation

36, Lenin ave., Tomsk, 634050, Russian Federation

rvvt@cardio-tomsk.ruФедороваС. Б.FedorovaS. B.

младший научный сотрудник, врач-кардиолог отделения неотложной кардиологии

634012, Российская Федерация, Томск, ул. Киевская, 111а

Research Fellow at the Department of Emergency Cardiology

111a, Kievskaya str., Tomsk, 634012, Russian Federation

gomboevasayana@gmail.comВышловЕ. В.VyshlovE. V.

д-р мед. наук, ведущий научный сотрудник отделения неотложной кардиологии

634012, Российская Федерация, Томск, ул. Киевская, 111а

634050, Российская Федерация, Томск, Московский тракт, 2

Dr. Sci. (Med.), Leading Research Fellow at the Department of Emergency Cardiology

111a, Kievskaya str., Tomsk, 634012, Russian Federation

2, Moskovsky tract, Tomsk, 634050, Russian Federation

evv@cardio-tomsk.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр, Сибирский государственный медицинский университет, Национальный исследовательский Томский государственный университетРоссияCardiology Research Institute, Tomsk National Research Medical Center Siberian State Medical University National Research Tomsk State UniversityRussian FederationНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центрРоссияCardiology Research Institute, Tomsk National Research Medical CenterRussian FederationНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр, Сибирский государственный медицинский университетРоссияCardiology Research Institute, Tomsk National Research Medical Center Siberian State Medical UniversityRussian Federation2018120220193341018Copyright © Рябов В.В., Федорова С.Б., Вышлов Е.В., 20192019Рябов В.В., Федорова С.Б., Вышлов Е.В.Ryabov V.V., Fedorova S.B., Vyshlov E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/606

Инфаркт миокарда без обструктивного коронарного атеросклероза — понятие, которое появилось относительно недавно, но которое имеет большое значение для текущей клинической практики. Под «маской» этого диагноза скрывается не только инфаркт миокарда как результат ишемии, но и заболевания с другими механизмами повреждения миокарда. В обзоре представлено определение этого понятия, алгоритм дифференциальной диагностики различных заболеваний, которые сопровождаются повышением маркеров повреждения миокарда. Акцент сделан на магнитно-резонансной томографии как ключевом методе диагностики заболеваний миокарда. Представлены основные положения современных рекомендаций по этому вопросу. Обсуждены открытые неразработанные аспекты этой проблемы, намечены направления дальнейших исследований.

Myocardial infarction with nonobstructive coronary atherosclerosis is a term which emerged recently, but it is of great importance for current clinical practice. Under the mask of this diagnosis, not only ischemia-caused myocardial infarction is hiding, but also diseases with alternative mechanisms of myocardial injury. This review presents a definition of this term as well as differential diagnostic algorithm for diseases associated with increase in the myocardial injury markers. The role of magnetic resonance imaging is emphasized as it is the key method for diagnosis of cardiac diseases. Main principles of current recommendations in this regard are presented. Unsolved and undeveloped aspects of this problem are discussed. Directions for future research are outlined.

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