Роль магнитно-резонансной томографии сердца в определении прогноза больных с острым инфарктом миокарда с подъемом сегмента ST. Часть 2. Оценка прогноза заболевания - Журнал Терапевтический архив №4 Вопросы диагностики внутренних болезней 2022

Роль магнитно-резонансной томографии сердца в определении прогноза больных с острым инфарктом миокарда с подъемом сегмента ST. Часть 2. Оценка прогноза заболевания

Тереничева М.А., Стукалова О.В., Шахнович Р.М., Терновой С.К. Роль магнитно-резонансной томографии сердца в определении прогноза больных с острым инфарктом миокарда с подъемом сегмента ST. Часть 2. Оценка прогноза заболевания. Терапевтический архив. 2022;94(4):552–557.
DOI: 10.26442/00403660.2022.04.201458

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Terenicheva MA, Stukalova OV, Shakhnovich RM, Ternovoy SK. The role of cardiac magnetic resonance imaging in defining the prognosis of patients with acute ST-segment elevation myocardial infarction. Part 2. Assessment of the disease prognosis. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(4):552–557.
DOI: 10.26442/00403660.2022.04.201458

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Аннотация

В настоящее время сохраняется тенденция к росту заболеваемости хронической сердечной недостаточностью после перенесенного инфаркта миокарда (ИМ) с подъемом сегмента ST (ИМпST). В настоящее время единственным эффективным методом лечения острого ИМпST, способным уменьшить размер ИМ, является реперфузионная терапия. Таким образом, крайне актуален поиск нового кардиопротективного лечения, способного повлиять на прогноз данной категории больных. Благодаря развитию методик магнитно-резонансной томографии сердца в последние годы были установлены новые характеристики ИМ, влияющие на развитие хронической сердечной недостаточности и внезапной сердечной смерти. На основании этих показателей возможно формирование новых групп риска неблагоприятного прогноза среди больных с ИМпST, также они могут служить мишенями для разработки новой кардиопротективной терапии, чему и посвящена вторая часть обзора.

Ключевые слова: острый инфаркт миокарда с подъемом сегмента ST, внезапная сердечная смерть, магнитно-резонансная томография сердца с контрастированием, отек миокарда, размер инфаркта, гетерогенная зона, микрососудистая обструкция, интрамиокардиальное кровоизлияние

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Currently the incidence of congestive heart failure after ST-segment elevation myocardial infarction (STEMI) tends to increase. Reperfusion therapy is still the only effective method to reduce an infarct size. Therefore, there is a high unmet need of novel cardioprotective treatments that would improve outcomes in such patients. Recent advances in cardiovascular magnetic resonance (CMR) methods enabled the identification of certain new infarct characteristics associated with the development of heart failure and sudden cardiac death. These characteristics can help identify new groups of high risk patients and used as a targets for novel cardioprotective treatments. This part of the review summarizes novel CMR-based characteristics of myocardial infarction and their role in the prognostic stratification of STEMI patients.

Keywords: ST-segment elevation myocardial infarction, sudden cardiac death, cardiovascular magnetic resonance, myocardial edema, infarct size, myocardial heterogeneity, microvascular obstruction, intramyocardial hemorrhage

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Авторы

М.А. Тереничева*1, О.В. Стукалова1, Р.М. Шахнович1, С.К. Терновой1,2

1 Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*starcad@bk.ru

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Mariya A. Terenicheva*1, Olga V. Stukalova1, Roman M. Shakhnovich1, Sergey K. Ternovoy1,2

1 Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology, Moscow, Russia;
2 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*starcad@bk.ru

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