cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2019-34-3-53-59cardiotomsk-813Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESКардиальная патология у пациентов с резистентной артериальной гипертониейCardiac pathology in patients with resistant hypertensionhttps://orcid.org/0000-0002-2238-4573МордовинВ. Ф.MordovinV. F.

д-р мед. наук, профессор, заведующий отделением артериальных гипертоний, Научно-исследовательский институт кардиологии, 

Научно-исследовательский институт кардиологии, 634012, Томск, ул. Киевская, 111а

Dr. Sci. (Med.), Professor, Head of the Department of Hypertension, Cardiology Research Institute,

111a, Kievskaya str., Tomsk, 634012

mordovin@cardio-tomsk.ruhttps://orcid.org/0000-0001-5898-0361РиппТ. М.RippT. M.

д-р мед. наук, ведущий научный сотрудник отделения артериальных гипертоний, Научно-исследовательский институт кардиологии, 634012, Томск, ул. Киевская, 111а;

доцент Сибирского государственного медицинского университета Министерства здравоохранения Российской Федерации,

rripp@mail.ru

Dr. Sci. (Med.), Leading Research Scientist, Department of Hypertension, Cardiology Research Institute; Assistant Professor of the Siberian State Medical University,

111a, Kievskaya str., Tomsk, 634012

ripp@cardio-tomsk.ruhttps://orcid.org/0000-0002-0988-3642СитковаЕ. С.SitkovaE. S.

научный сотрудник отделения артериальных гипертоний, Научно-исследовательский институт кардиологии, 

634012, Томск, ул. Киевская, 111а

Research Scientist, Department of Hypertension, Cardiology Research Institute, 

111a, Kievskaya str., Tomsk, 634012

chekruzhova@mail.ruТомский национальный исследовательский медицинский центр Российской академии наукРоссияTomsk National Research Medical Center, Russian Academy of SciencesRussian Federation2019011120193435359Copyright © Мордовин В.Ф., Рипп Т.М., Ситкова Е.С., 20192019Мордовин В.Ф., Рипп Т.М., Ситкова Е.С.Mordovin V.F., Ripp T.M., Sitkova E.S.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/813

Кардиальные изменения у пациентов с резистентной артериальной гипертонией (АГ) имеют высокую частоту встречаемости. В частности, гипертрофия левого желудочка (ГЛЖ) и снижение коронарного резерва играют самостоятельную роль в определении риска кардиоваскулярных осложнений. Диагностические подходы к их выявлению в настоящее время представлены широким спектром высокоинформативных исследований с использованием современного ультразвукового оборудования, магнитно-резонансного томографа, компьютерного томографа, гамма-камеры. Активное изучение вовлечения каскада патофизиологических механизмов в развитие кардиальных изменений при АГ позволяет не только выявлять факторы, связанные с тяжестью поражения, но и находить новые точки приложения для реализации кардиопротекции и снижения сердечно-сосудистого риска. Наряду с медикаментозными возможностями в настоящее время активно изучается метод ренальной денервации. Несмотря на высокую вариабельность результатов и их плохую предсказуемость, ряд исследований показывает эффективность данного метода в коррекции структурно-функционального состояния миокарда, что имеет важное прогностическое значение при резистентной АГ.

Patients with resistant arterial hypertension have a high prevalence of cardiac pathology. In particular, left ventricular hypertrophy and reduced coronary reserve play independent role in determining the risk of cardiovascular complications. Diagnostic approaches to their detection are currently represented by a wide range of highly informative studies using modern ultrasound equipment, magnetic resonance imaging, computed tomography scanner, and gamma camera. The active study of the involvement of the cascade of pathophysiological mechanisms in the development of cardiac changes in hypertension allows not only to identify the factors associated with the severity of the lesion, but also to find new application points for the cardioprotection and to reduce cardiovascular risk. Along with the pharmacological capabilities, the renal denervation method is currently under active study. Despite high variability of the results and their poor predictability, a number of studies show the efficiency of this method in correcting the structural and functional changes in the heart, which is of important prognostic value for resistant hypertension.

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