Митральная недостаточность при дисплазии соединительной ткани. Что должен знать врач сегодня?
Митральная недостаточность при дисплазии соединительной ткани. Что должен знать врач сегодня?
Мартьянова Ю.Б., Чернышева Е.Н., Кондратьев Д.А., Дземешкевич С.Л., Тарасов Д.Г., Лялюкова Е.А. Митральная недостаточность при дисплазии соединительной ткани. Что должен знать врач сегодня? CardioСоматика. 2022;13(1):44–50. DOI: 10.17816/22217185.2022.1.201481
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Martyanova YuB, Chernysheva EN, Kondratiev DA, Dzemeshkevich SL, Tarasov DG, Ljaljukova EA. The mitral insufficiency in connective tissue dysplasia. What should a doctor know today? A review. Cardiosomatics. 2022;13(1):44–50. DOI: 10.17816/22217185.2022.1.201481
Митральная недостаточность при дисплазии соединительной ткани. Что должен знать врач сегодня?
Мартьянова Ю.Б., Чернышева Е.Н., Кондратьев Д.А., Дземешкевич С.Л., Тарасов Д.Г., Лялюкова Е.А. Митральная недостаточность при дисплазии соединительной ткани. Что должен знать врач сегодня? CardioСоматика. 2022;13(1):44–50. DOI: 10.17816/22217185.2022.1.201481
________________________________________________
Martyanova YuB, Chernysheva EN, Kondratiev DA, Dzemeshkevich SL, Tarasov DG, Ljaljukova EA. The mitral insufficiency in connective tissue dysplasia. What should a doctor know today? A review. Cardiosomatics. 2022;13(1):44–50. DOI: 10.17816/22217185.2022.1.201481
Проблема дисфункции митрального клапана (МК) как в изолированном виде, так и в сочетании с другими аномалиями и поражениями соединительнотканных структур весьма актуальна. Митральная недостаточность (МН) при дисплазии соединительной ткани является наиболее частой клапанной патологией, сопровождающейся разной степенью выраженности. В настоящее время изучено проградиентное развитие функциональной и клинической симптоматики этого порока, уточнены и пересмотрены вопросы, касающиеся эпидемиологии, диагностики и прогноза. Очень важным остается вопрос постановки корректного диагноза, выбора времени и метода лечения, решения вопроса о возможности клапаносохраняющей операции или протезирования МК, оптимально подходящего в конкретной клинической ситуации. Все этапы практического алгоритма зависят от клинического и хирургического опыта лечебного учреждения, занимающегося этой патологией. Целью статьи является расширение знаний специалистов практического здравоохранения в вопросе МН при дисплазии соединительной ткани, начиная от модели cтроения МК до современных методов лечения, описанных в литературе.
The problem of the mitral valve (MV) dysfunction, both in isolation and combination forms with other anomalies and lesions of connective tissue structures, is very current. Mitral insufficiency (MI) in case of the connective tissue dysplasia is the most common valvular pathology, accompanied by different degrees of severity. Nowadays the progradient development of functional and clinical symptoms of this disease has been studied, the questions of epidemiology, diagnosis and prognosis have been clarified and reconsidered. There are important issues of correct diagnosis, time and method of treatment, the decision of usage a valve-repair or valve prosthesis in the certain clinical situation.
All these practical algorithm steps depend on the clinical and surgical experience of the medical institutions which work with this pathology. The purpose of this article is to expand the knowledge of practical doctors in the issue of MI in case of connective tissue dysplasia, including the questions from the model of the MV structure to modern methods of treatment which are described in the contemporary literature.
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1. Dzemeshkevich SL, Stivenson LU. Bolezni mitral'nogo klapana. Funktsiia, diagnostika, lechenie. 2-e izd., dop. Moscow: GEOTAR-Media, 2015 (in Russian).
2. Freed LA, Levy D, Levine RA, et al. Prevalence and outcome of mitral valve prolapse. N Engl J Med. 1999;341(1):1-7. DOI:10.1056/NEJM199907013410101
3. Mitrofanova LB. Klapannye poroki serdtsa. Novyi vzgliad na etiologiiu, patogenez i morfologiiu. Saint Petersburg: Meditsinskoe izdatel'stvo, 2007 (in Russian).
4. Zemtsovskii EV, Malev EG, Berezovskaia GA, et al. Nasledstvennye narusheniia soedinitel'noi tkani v kardiologii. Diagnostika i lechenie. Rossiiskie rekomendatsii (I peresmotr). Russian Journal of Cardiology. 2013;1(99, Suppl. 1):1-32. Available at: https://www.dzhmao.ru/spez/RKO/recom2012_soedTkani.pdf. Accessed: 21.06.2022 (in Russian).
6. Кlemenov AV. Mitral valve prolapse: current views and challenges (review). Sovremennye tehnologii v medicine. 2017;9(3):126-37 (in Russian). DOI:10.17691/stm2017.9.3.17
7. Rabkin E, Aikawa M, Stone JR, et al. Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in myxomatous heart valves. Circulation 2001;104(21):2525-32. DOI:10.1161/hc4601.099489
8. Guy TS, Hill AC. Mitral valve prolapse. Annu Rev Med. 2012;63(1):277-92. DOI:10.1146/annurev-med-022811-091602
9. Cole VG, Chan D, Hickey A, Wilcken D.E. Collagen composition of normal and myxomatous human mitral heart valves. Biochem J. 1984;219(2):451. DOI:10.1042/bj2190451
10. Barber JE, Kasper FK, Ratliff NB, et al. Mechanical properties of myxomatous mitral valves. J Thorac Cardiovasc Surg. 2001;122(5):995. DOI:10.1067/mtc.2001.117621
11. Adams DH, Carabello BA, Castillo J. Mitral valve regurgitation. In: Fuster V, Walsh RA, Harrington RA, eds. Hurst’s the Heart. 13th ed. New York: McGraw-Hill, 2010, p. 1721-37.
12. Hayek E, Gring CN, Griffin BP. Mitral valve prolapse. Lancet. 2005;365(9458):507-18. DOI:10.1016/S0140-6736(05)17869-6
13. Avierinos JF, Gersh BJ, Melton LJ, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation. 2002;106(11):1355-61. DOI:10.1161/01.cir.0000028933.34260.09
14. Silbiger JJ. Anatomy, mechanics, and pathophysiology of the mitral annulus. Am Heart J. 2012;164(2):163-76. DOI:10.1016/j.ahj.2012.05.014
15. Niu Z, Chan V, Mesana T, Ruel M. The evolution of mitral valve prolapse: insights, from the Framingham Heart Study. J Thorac Dis. 2016;8(8):E827-8. DOI:10.21037/jtd.2016.07.58
16. Delling FN, Rong J, Larson MG, et al. Evolution of mitral valve prolapse: insights from the Framingham Heart Study. Circulation. 2016;133(17):1688‑95. DOI:10.1161/CIRCULATIONAHA.115.020621
17. Salustri A, Almaghrabi A. Mitral valve disease correlation between the most important echocardiographic parameters and haemodynamics. e-Journal Cardiol Pract. 2018;16(24). Available at: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Mitral-Valve-Disease-co.... Accessed: 21.06.2022.
18. Bayer-Topilsky T, Suri RM, Topilsky Y, et al. Mitral valve prolapse, psychoemotional status, and quality of life: prospective investigation in the current era. Am J Med. 2016;129(10):1100-9. DOI:10.1016/j.amjmed.2016.05.004
19. Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: the Framingham Study. Am J Public Health Nations Health. 1951;41(3):279-86. DOI:10.2105/ajph.41.3.279
20. Zemtsovsky EV, Malev EG. Mitral valve prolapse: modern approach to the problem. Bulletin of Almazov Federal Heart, Blood and Endocrinology Centre. 2011;3:25-30 (in Russian).
21. Enriquez-Sarano M, Basmadjian AJ, Rossy A, et al. Progression of mitral regurgitation: a prospective Doppler echocardiographic study. J Am Coll Cardiol. 1999;34(4):1137-44. DOI:10.1016/s0735-1097(99)00313-7
22. Samad Z, Kaul P, Shaw LK, et al. Impact of early surgery on survival of patients with severe mitral regurgitation. Heart. 2011;97(3):221. DOI:10.1136/hrt.2010.202432
23. Avierinos JF, Inamo J, Grigioni F, et al. Sex differences in morphology and outcomes of mitral valve prolapse. Ann Intern Med. 2008;149(11):787-95.
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1 ФГБУ «Федеральный центр сердечно-сосудистой хирургии» Минздрава России, Астрахань, Россия;
2 ФГБОУ ВО «Астраханский государственный медицинский университет» Минздрава России, Астрахань, Россия;
3 ФГБНУ «Российский научный центр хирургии им. акад. Б.В. Петровского», Москва, Россия;
4 ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия
*martyanova911@mail.ru
________________________________________________
Yulia B. Martyanova*1, Elena N. Chernysheva2, Dmitry A. Kondratiev1, Sergei L. Dzemeshkevich3, Dmitry G. Tarasov1, Elena A. Ljaljukova4
1 Federal Center for Cardiovascular Surgery, Astrakhan, Russiа;
2 Astrakhan State Medical University, Astrakhan, Russiа;
3 Petrovsky National Research Center of Surgery, Moscow, Russiа;
4 Omsk State Medical University, Omsk, Russiа
*martyanova911@mail.ru