Миокардит предсердий у пациентки с артериитом Такаясу
DOI: 10.26442/00403660.2019.06.000047
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Safiullina A.A., Uskach T.M., Zhirov I.V., et al. Atrial myocarditis in a patient with Takayasu arteritis. Therapeutic Archive. 2019; 91 (6): 103–109. DOI: 10.26442/00403660.2019.06.000047
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Ключевые слова: артериит Такаясу, миокардит предсердий, магнитно-резонансная томография.
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Takayasu arteritis belongs to the group of systemic vasculitis with a predominant lesion of large-caliber vessels and the development of stenosis of their lumen. In world practice, to establish the diagnosis of arteritis Takayasu apply the criteria proposed by the American College of rheumatologists. Currently, there are no randomized clinical trials related to the disease, and the diagnosis and treatment of patients are based on a number of small studies, a series of clinical cases and expert opinion. The described clinical observation of a patient with Takayasu arteritis is of interest in connection with the detected atrial myocarditis during MRI diagnosis of the heart with contrast, which allows us to discuss the feasibility of this imaging technique in complex and doubtful cases.
Keywords: Takayasu's arteritis, atrial myocarditis, magnetic resonance imaging.
2. Takayasu M. A case with peculiar changes of the central retinal vessels. Acta Societatisophthalmologicae Japonicae. Tokyo, 1908. P. 12, 554-5.
3. Onen F, Akkoc N. Epidemiology of Takayasu arteritis. Presse Med. 2017;46(7-8 Pt 2):197-203. Epub 2017 Jul 26. doi: 10.1016/j.lpm.2017.05.034
4. Takamura C, Ohhigashi H, Ebana Y, Isobe M. New human leukocyte antigen risk allele in Japanese patients with Takayasu arteritis. Circ J. 2012;76:1697-702. doi: 10.1253/circj.cj-12-0089
5. González-Galarza FF, Takeshita LY, Santos EJ, Kempson F, Maia MH, Da Silva AL, Teles e Silva AL, Ghattaoraya GS, Alfirevic A, Jones AR, et al. Allele frequency net 2015 update: New features for HLA epitopes, KIR and disease and HLA adverse drug reaction associations. Nucleic Acids Res. 2015;43:D784-D788. doi: 10.1093/nar/gku1166
6. Kothari SS. Takayasu's arteritis in children – a review. Imag Ped Cardiol. 2001;3(4):4-23. doi: 10.1111/ijcp.12993
7. Чихладзе Н.М., Сивакова О.А., Чазова И.Е. Клинические проявления поражения сердечнососудистой системы при неспецифическом аортоартериите. Системные гипертензии. 2008;(4):22-4 [Сhikhladze NM, Sivakova OA, Chazova IE. Clinical manifestations of the cardiovascular system defeat with nonspecific aortoarteriitis. Systemnye Gipertenzii = Systemic Hypertension. 2008;(4):22-4 (In Russ.)].
8. Pacheco RL, Latorraca COC, de Souza AWS, Pachito DV, Riera R. Clinical interventions for Takayasu arteritis: A systematic review. Int J Clin Pract. 2017 Nov;71(11). doi: 10.1111/ijcp.12993
9. Goel R, Danda D, Joseph G, Ravindran R, Kumar S, Jayaseelan V, Jayaseelan L, Bacon P. Longterm outcome of 251 patients with Takayasu arteritis on combination immunosuppressant therapy: single centre experience from a large tertiary care teaching hospital in Southern India. Semin Arthritis Rheum. 2018;47:718-26. doi: 10.1016/j.semarthrit.2017.09.014
10. Comarmond C, Biard L, Lambert M, Mekinian A, Ferfar Y, Kahn JE, Benhamou Y, Chiche L, Koskas F, Cluzel P, Hachulla E, Messas E, Resche-Rigon M, Cacoub P, Mirault T, Saadoun D; French Takayasu Network. Long-term outcomes and prognostic factors of complications in Takayasu arteritis: a multicenter study of 318 patients. Circulation. 2017;136:1114-22. doi: 10.1161/CIRCULATIONAHA.116.027094
11. Schmidt J, Kermani TA, Bacani AK, Crowson CS, Cooper LT, Matteson EL, Warrington KJ. Diagnostic features, treatment, and outcomes of Takayasu arteritis in a US cohort of 126 patients. Mayo Clin Proc. 2013;88:822-30. doi: 10.1016/j.mayocp.2013.04.025
12. Park SJ, Kim HJ, Park H, Hann HJ, Kim KH, Han S, Kim Y, Ahn HS. Incidence, prevalence, mortality and causes of death in Takayasu Arteritis in Korea – a nationwide, population-based study. Int J Cardiol. 2017;235:100-4. doi: 10.1016/j.ijcard.2017.04.013
13. Subramanyan R, Joy J, Balakrishnan KG. Natural history of aortoarteritis (Takayasu's disease). Circulation. 1989;80:429‐37.
14. Kim H, Barra L. Ischemic complications in Takayasu’s arteritis: A meta-analysis. Semin Arthritis Rheum. 2018 Jun;47(6):900-6. doi: 10.1016/j.semarthrit.2017.11.001
15. Serra R, Butrico L, Fugetto F, Chibireva MD, Malva A, De Caridi G, Massara M, Barbetta A, Cannistrà M, de Franciscis S. Updates in Pathophysiology, Diagnosis and Management of Takayasu Arteritis. Ann Vasc Surg. 2016;35:210-25. doi: 10.1016/j.avsg.2016.02.011
16. Li J, Sun F, Chen Z, Yang Y, Zhao J, Li M, Tian X, Zeng X. The clinical characteristics of Chinese Takayasu’s arteritis patients: A retrospective study of 411 patients over 24 years. Arthritis Res Ther. 2017;19:107. doi: 10.1186/s13075-017-1307-z
17. Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, Ozer HT, Seyahi E, Akar S, Onen F, Cefle A, Aydin SZ, Yilmaz N, Onat AM, Cobankara V, Tunc E, Ozturk MA, Fresko I, Karaaslan Y, Akkoc N, Yücel AE, Kiraz S, Keser G, Inanc M, Direskeneli H. Takayasu’s arteritis in Turkey – clinical and angiographic features of 248 patients. Clin Exp Rheumatol. 2009;27:S59-S64. PMID: 19646348
18. Soto ME, Espinola N, Flores-Suarez LF, Reyes PA. Takayasu arteritis: Clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol. 2008;26:S9-S15. PMID: 18799047
19. Alibaz-Oner F, Direskeneli H. Update on Takayasu’s arteritis. Presse Med. 2015;44:e259-e265. doi: 10.1016/j.lpm.2015.01.015
20. Li J, Li H, Sun F, Chen Z, Yang Y, Zhao J, Li M, Tian X, Zeng X. Clinical Characteristics of Heart Involvement in Chinese Patients with Takayasu Arteritis. J Rheumatol. 2017;44:1867-74. doi: 10.3899/jrheum.161514
21. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990 Aug;33(8):1129-34.
22. Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, Brouwer E, Cimmino MA, Clark E, Dasgupta B, Diamantopoulos AP, Direskeneli H, Iagnocco A, Klink T, Neill L, Ponte C, Salvarani C, Slart RHJA, Whitlock M, Schmidt WA. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018 May;77(5):636-43. doi: 10.1136/annrheumdis-2017-212649
23. Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996;54(l):S155-63. PMID: 9119518
24. Perera AH, Mason JC, Wolfe JH. Takayasu Arteritis: Criteria for Surgical Intervention Should Not Be Ignored. Int J Vasc Med. 2013. doi: 10.1155/2013/618910
25. Desai MY, Stone JH, Foo TK, Hellmann DB, Lima JA, Bluemke DA. Delayed contrast-enhanced MRI of the aortic wall in Takayasu's arteritis: initial experience. AJR Am J Roentgenol. 2005;184:1427-31. doi: 10.2214/ajr.184.5.01841427
26. Choe YH, Han BK, Koh EM, Kim DK, Do YS, Lee WR. Takayasu's arteritis: assessment of disease activity with contrast-enhanced MR imaging. AJR Am J Roentgenol. 2000;175:505-11. doi: 10.2214/ajr.175.2.1750505
27. Jiang L, Li D, Yan F, Dai X, Li Y, Ma L. Evaluation of Takayasu arteritis activity by delayed contrast-enhanced magnetic resonance imaging. Int J Cardiol. 2012;155(2):262-7. doi: 10.1016/j.ijcard.2010.10.002
28. Tso E, Flamm SD, White RD, Schvartzman PR, Mascha E, Hoffman GS. Takayasu arteritis: utility and limitations of magnetic resonance imaging in diagnosis and treatment. Arthritis Rheum. 2002;46:1634-42. doi: 10.1002/art.10251
29. Hoffman GS. Takayasu arteritis: lessons from the American National Institutes of Health experience. Int J Cardiol. 1996;54 Suppl:S99-102.
30. Mekinian A, Comarmond C, Resche-Rigon M, Mirault T, Kahn JE, Lambert M, Sibilia J, Néel A, Cohen P, Hie M, Berthier S, Marie I, Lavigne C, Anne Vandenhende M, Muller G, Amoura Z, Devilliers H, Abad S, Hamidou M, Guillevin L, Dhote R, Godeau B, Messas E, Cacoub P, Fain O, Saadoun D; French Takayasu Network.nEfficacy of Biological-Targeted Treatments in Takayasu Arteritis: Multicenter, Retrospective Study of 49 Patients. Circulation. 2015;132:1693-700. doi: 10.1161/CIRCULATIONAHA.114.014321
31. Ferfar Y, Mirault T, Desbois AC, Comarmond C, Messas E, Savey L, Domont F, Cacoub P, Saadoun D. Biotherapies in large vessel vasculitis. Autoimmun Rev. 2016;15:544-51. doi: 10.1016/j.autrev.2016.02.012
32. Langford CA, Cuthbertson D, Ytterberg SR, Khalidi N, Monach PA, Carette S, Seo P, Moreland LW, Weisman M, Koening CL. A Randomized, Double-Blind Trial of Abatacept (CTLA-4Ig) for the Treatment of Takayasu Arteritis. Arthritis Rheum. 2017;9:846-53. doi: 10.1002/art.40037
33. Nakaoka Y, Isobe M, Takei S, Tanaka Y, Ishii T, Yokota S, Nomura A, Yoshida S, Nishimoto N. Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: Results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study). Ann Rheum Dis. 2018;77:348-54. doi: 10.1136/annrheumdis-2017-211878
34. Chhetri MK, Pal NC, Neelakantan C, Chowdhury ND, Mullick KC. Endocardial lesion in a case of Takayasu's arteriopathy. Br Heart J. 1970 Nov;32(6):859-62.
35. Alcalde Ó, Cabrera Gómez S, Vallès Gras E, Benito Villabriga B, Zuccarino F, Martí-Almor J. Rheumatoid Arthritis With Severe Atrial Fibrosis and Multiple Atrial Arrhythmias: Chronic Atrial Myocarditis? Rev Esp Cardiol (Engl Ed). 2018 May;71(5):396-7. doi: 10.1016/j.rec.2017.04.003
36. Larsen BT, Maleszewski JJ, Edwards WD, Cooper LT Jr, Sobonya RE, Thompson VE, Duckett SG, Peebles CR, Simpson IA, Tazelaar HD. Atrial giant cell myocarditis: a distinctive clinicopathologic entity. Circulation. 2013 Jan 1;127(1):39-47. doi: 10.1161/CIRCULATIONAHA.112.128900
37. Mavrogeni S, Manoussakis MN. Myocarditis and subclavian stenosis in Takayasu arteritis. Int J Cardiol. 2011 Apr 14;148(2):223-4. doi: 10.1016/j.ijcard.2009.05.008
38. Mavrogeni S, Sfikakis P, Dimitroulas T, Kolovou G, Kitas GD. Edema and fibrosis imaging by cardiovascular magnetic resonance: how can the experience of Cardiology be best utilized in rheumatological practice? Semin Arthritis Rheum. 2014 Aug;44(1):76-85. doi: 10.1016/j.semarthrit.2014.01.005
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1. Sugiyama K, Ijiri S, Tagawa S, Shimizu K. Takayasu disease on the centenary of its discovery. Jpn J Ophthalmol. 2009;53:81-91. doi: 10.1007/s10384-009-0650-2
2. Takayasu M. A case with peculiar changes of the central retinal vessels. Acta Societatisophthalmologicae Japonicae. Tokyo, 1908. P. 12, 554-5.
3. Onen F, Akkoc N. Epidemiology of Takayasu arteritis. Presse Med. 2017;46(7-8 Pt 2):197-203. Epub 2017 Jul 26. doi: 10.1016/j.lpm.2017.05.034
4. Takamura C, Ohhigashi H, Ebana Y, Isobe M. New human leukocyte antigen risk allele in Japanese patients with Takayasu arteritis. Circ J. 2012;76:1697-702. doi: 10.1253/circj.cj-12-0089
5. González-Galarza FF, Takeshita LY, Santos EJ, Kempson F, Maia MH, Da Silva AL, Teles e Silva AL, Ghattaoraya GS, Alfirevic A, Jones AR, et al. Allele frequency net 2015 update: New features for HLA epitopes, KIR and disease and HLA adverse drug reaction associations. Nucleic Acids Res. 2015;43:D784-D788. doi: 10.1093/nar/gku1166
6. Kothari SS. Takayasu's arteritis in children – a review. Imag Ped Cardiol. 2001;3(4):4-23. doi: 10.1111/ijcp.12993
7. Сhikhladze NM, Sivakova OA, Chazova IE. Clinical manifestations of the cardiovascular system defeat with nonspecific aortoarteriitis. Systemnye Gipertenzii = Systemic Hypertension. 2008;(4):22-4 (In Russ.)
8. Pacheco RL, Latorraca COC, de Souza AWS, Pachito DV, Riera R. Clinical interventions for Takayasu arteritis: A systematic review. Int J Clin Pract. 2017 Nov;71(11). doi: 10.1111/ijcp.12993
9. Goel R, Danda D, Joseph G, Ravindran R, Kumar S, Jayaseelan V, Jayaseelan L, Bacon P. Longterm outcome of 251 patients with Takayasu arteritis on combination immunosuppressant therapy: single centre experience from a large tertiary care teaching hospital in Southern India. Semin Arthritis Rheum. 2018;47:718-26. doi: 10.1016/j.semarthrit.2017.09.014
10. Comarmond C, Biard L, Lambert M, Mekinian A, Ferfar Y, Kahn JE, Benhamou Y, Chiche L, Koskas F, Cluzel P, Hachulla E, Messas E, Resche-Rigon M, Cacoub P, Mirault T, Saadoun D; French Takayasu Network. Long-term outcomes and prognostic factors of complications in Takayasu arteritis: a multicenter study of 318 patients. Circulation. 2017;136:1114-22. doi: 10.1161/CIRCULATIONAHA.116.027094
11. Schmidt J, Kermani TA, Bacani AK, Crowson CS, Cooper LT, Matteson EL, Warrington KJ. Diagnostic features, treatment, and outcomes of Takayasu arteritis in a US cohort of 126 patients. Mayo Clin Proc. 2013;88:822-30. doi: 10.1016/j.mayocp.2013.04.025
12. Park SJ, Kim HJ, Park H, Hann HJ, Kim KH, Han S, Kim Y, Ahn HS. Incidence, prevalence, mortality and causes of death in Takayasu Arteritis in Korea – a nationwide, population-based study. Int J Cardiol. 2017;235:100-4. doi: 10.1016/j.ijcard.2017.04.013
13. Subramanyan R, Joy J, Balakrishnan KG. Natural history of aortoarteritis (Takayasu's disease). Circulation. 1989;80:429‐37.
14. Kim H, Barra L. Ischemic complications in Takayasu’s arteritis: A meta-analysis. Semin Arthritis Rheum. 2018 Jun;47(6):900-6. doi: 10.1016/j.semarthrit.2017.11.001
15. Serra R, Butrico L, Fugetto F, Chibireva MD, Malva A, De Caridi G, Massara M, Barbetta A, Cannistrà M, de Franciscis S. Updates in Pathophysiology, Diagnosis and Management of Takayasu Arteritis. Ann Vasc Surg. 2016;35:210-25. doi: 10.1016/j.avsg.2016.02.011
16. Li J, Sun F, Chen Z, Yang Y, Zhao J, Li M, Tian X, Zeng X. The clinical characteristics of Chinese Takayasu’s arteritis patients: A retrospective study of 411 patients over 24 years. Arthritis Res Ther. 2017;19:107. doi: 10.1186/s13075-017-1307-z
17. Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, Ozer HT, Seyahi E, Akar S, Onen F, Cefle A, Aydin SZ, Yilmaz N, Onat AM, Cobankara V, Tunc E, Ozturk MA, Fresko I, Karaaslan Y, Akkoc N, Yücel AE, Kiraz S, Keser G, Inanc M, Direskeneli H. Takayasu’s arteritis in Turkey – clinical and angiographic features of 248 patients. Clin Exp Rheumatol. 2009;27:S59-S64. PMID: 19646348
18. Soto ME, Espinola N, Flores-Suarez LF, Reyes PA. Takayasu arteritis: Clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol. 2008;26:S9-S15. PMID: 18799047
19. Alibaz-Oner F, Direskeneli H. Update on Takayasu’s arteritis. Presse Med. 2015;44:e259-e265. doi: 10.1016/j.lpm.2015.01.015
20. Li J, Li H, Sun F, Chen Z, Yang Y, Zhao J, Li M, Tian X, Zeng X. Clinical Characteristics of Heart Involvement in Chinese Patients with Takayasu Arteritis. J Rheumatol. 2017;44:1867-74. doi: 10.3899/jrheum.161514
21. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990 Aug;33(8):1129-34.
22. Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, Brouwer E, Cimmino MA, Clark E, Dasgupta B, Diamantopoulos AP, Direskeneli H, Iagnocco A, Klink T, Neill L, Ponte C, Salvarani C, Slart RHJA, Whitlock M, Schmidt WA. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018 May;77(5):636-43. doi: 10.1136/annrheumdis-2017-212649
23. Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996;54(l):S155-63. PMID: 9119518
24. Perera AH, Mason JC, Wolfe JH. Takayasu Arteritis: Criteria for Surgical Intervention Should Not Be Ignored. Int J Vasc Med. 2013. doi: 10.1155/2013/618910
25. Desai MY, Stone JH, Foo TK, Hellmann DB, Lima JA, Bluemke DA. Delayed contrast-enhanced MRI of the aortic wall in Takayasu's arteritis: initial experience. AJR Am J Roentgenol. 2005;184:1427-31. doi: 10.2214/ajr.184.5.01841427
26. Choe YH, Han BK, Koh EM, Kim DK, Do YS, Lee WR. Takayasu's arteritis: assessment of disease activity with contrast-enhanced MR imaging. AJR Am J Roentgenol. 2000;175:505-11. doi: 10.2214/ajr.175.2.1750505
27. Jiang L, Li D, Yan F, Dai X, Li Y, Ma L. Evaluation of Takayasu arteritis activity by delayed contrast-enhanced magnetic resonance imaging. Int J Cardiol. 2012;155(2):262-7. doi: 10.1016/j.ijcard.2010.10.002
28. Tso E, Flamm SD, White RD, Schvartzman PR, Mascha E, Hoffman GS. Takayasu arteritis: utility and limitations of magnetic resonance imaging in diagnosis and treatment. Arthritis Rheum. 2002;46:1634-42. doi: 10.1002/art.10251
29. Hoffman GS. Takayasu arteritis: lessons from the American National Institutes of Health experience. Int J Cardiol. 1996;54 Suppl:S99-102.
30. Mekinian A, Comarmond C, Resche-Rigon M, Mirault T, Kahn JE, Lambert M, Sibilia J, Néel A, Cohen P, Hie M, Berthier S, Marie I, Lavigne C, Anne Vandenhende M, Muller G, Amoura Z, Devilliers H, Abad S, Hamidou M, Guillevin L, Dhote R, Godeau B, Messas E, Cacoub P, Fain O, Saadoun D; French Takayasu Network.nEfficacy of Biological-Targeted Treatments in Takayasu Arteritis: Multicenter, Retrospective Study of 49 Patients. Circulation. 2015;132:1693-700. doi: 10.1161/CIRCULATIONAHA.114.014321
31. Ferfar Y, Mirault T, Desbois AC, Comarmond C, Messas E, Savey L, Domont F, Cacoub P, Saadoun D. Biotherapies in large vessel vasculitis. Autoimmun Rev. 2016;15:544-51. doi: 10.1016/j.autrev.2016.02.012
32. Langford CA, Cuthbertson D, Ytterberg SR, Khalidi N, Monach PA, Carette S, Seo P, Moreland LW, Weisman M, Koening CL. A Randomized, Double-Blind Trial of Abatacept (CTLA-4Ig) for the Treatment of Takayasu Arteritis. Arthritis Rheum. 2017;9:846-53. doi: 10.1002/art.40037
33. Nakaoka Y, Isobe M, Takei S, Tanaka Y, Ishii T, Yokota S, Nomura A, Yoshida S, Nishimoto N. Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: Results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study). Ann Rheum Dis. 2018;77:348-54. doi: 10.1136/annrheumdis-2017-211878
34. Chhetri MK, Pal NC, Neelakantan C, Chowdhury ND, Mullick KC. Endocardial lesion in a case of Takayasu's arteriopathy. Br Heart J. 1970 Nov;32(6):859-62.
35. Alcalde Ó, Cabrera Gómez S, Vallès Gras E, Benito Villabriga B, Zuccarino F, Martí-Almor J. Rheumatoid Arthritis With Severe Atrial Fibrosis and Multiple Atrial Arrhythmias: Chronic Atrial Myocarditis? Rev Esp Cardiol (Engl Ed). 2018 May;71(5):396-7. doi: 10.1016/j.rec.2017.04.003
36. Larsen BT, Maleszewski JJ, Edwards WD, Cooper LT Jr, Sobonya RE, Thompson VE, Duckett SG, Peebles CR, Simpson IA, Tazelaar HD. Atrial giant cell myocarditis: a distinctive clinicopathologic entity. Circulation. 2013 Jan 1;127(1):39-47. doi: 10.1161/CIRCULATIONAHA.112.128900
37. Mavrogeni S, Manoussakis MN. Myocarditis and subclavian stenosis in Takayasu arteritis. Int J Cardiol. 2011 Apr 14;148(2):223-4. doi: 10.1016/j.ijcard.2009.05.008
38. Mavrogeni S, Sfikakis P, Dimitroulas T, Kolovou G, Kitas GD. Edema and fibrosis imaging by cardiovascular magnetic resonance: how can the experience of Cardiology be best utilized in rheumatological practice? Semin Arthritis Rheum. 2014 Aug;44(1):76-85. doi: 10.1016/j.semarthrit.2014.01.005
1 Научно-исследовательский институт кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
3 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
________________________________________________
A.A. Safiullina1, T.M. Uskach1,2, I.V. Zhirov1,2, O.A. Pogorelova1, O.V. Stukalova1,2, S.A. Gaman1, V.V. Gramovich1, P.I. Novikov3, S.N. Tereshchenko1,2
1 National Medical Research Center of Cardiology, Moscow, Russia;
2 Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
3 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia