References

cardiovascular

Кардиоваскулярная терапия и профилактика

Cardiovascular Therapy and Prevention

1728-88002619-0125

«SILICEA-POLIGRAF» LLC

cardiovascular-1792

Research Article

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Гипертрофия левого желудочка при артериальной гипертензии и риск развития аритмий

Left ventricular hypertrophy in arterial hypertension and arrhythmia risk

Фомина

И. Г.

Fomina

I. G.

tatamedic@mtu-net.ru

Дьякова

Т. А.

Dyakova

T. A.

tatamedic@mtu-net.ru

Московская медицинская академия им. И.М.Сеченова на базе ГКБ № 61. МоскваРоссияI.M. Sechenov Moscow Medical Academy, City Clinical Hospital No. 61. MoscowRussian Federation

2006

01011970

588389

1970

Фомина И.Г., Дьякова Т.А.

Fomina I.G., Dyakova T.A.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://cardiovascular.elpub.ru/jour/article/view/1792

Гипертрофия левого желудочка (ГЛЖ) является значимым независимым фактором риска не только общей и сердечно-сосудистой смертности, но и внезапной сердечной смерти. Вслед за повышением давления в гипертрофированном ЛЖ на фоне диастолической дисфункции миокарда очень быстро расширяется левое предсердие. Это приводит к возникновению наджелудочковой экстрасистолии, трепетанию и фибрилляции предсердий у 25%-50% пациентов с артериальной гипертонией (АГ). Связь между ГЛЖ, частотой и степенью выраженности желудочковых аритмий зависит от степени ГЛЖ и может отсутствовать на более близких к физиологическим ранних и средних стадиях. Ассоциация между ГЛЖ и спонтанно индуцированной желудочковой аритмией была подтверждена в хорошо контролируемых, экспериментальных исследованиях. К факторам аритмогенного риска у больных АГ с ГЛЖ относятся: поздние потенциалы желудочков, уменьшение вариабельности сердечного ритма, увеличение продолжительности QRS-комплекса и дисперсии интервала QT, а также альтернации Т-волны. Оценка риска развития аритмий у бессимптомных больных - трудная задача, которая может быть решена с помощью предложенного алгоритма.

Left ventricular hypertrophy (LVH) is an important, independent risk factor for not only total and cardiovascular mortality, but also for sudden cardiac death. Following blood pressure increase in hypertrophied LV, due to myocardial diastolic dysfunction, left atrium dilates very fast. That results in supraventricular extrasystolia, atrial fibrillation and flutter in 25-50% of the patients with arterial hypertension (AH). The link between LVH and ventricular arrhythmia incidence and severity depends on LVH stage, and might be absent at mild to moderate, close to physiological, stages. Association between LVH and spontaneously induced ventricular arrhythmia has been demonstrated in adequately controlled experimental studies. In AH and LVH patients, arrhythmogenic risk factors include the following: late ventricular potentials, decreased heart rate variability, prolonged QRS duration, increased T interval dispersion and T wave alteration. Assessing arrhythmia risk in asymptomatic patients is a difficult task, that could be solved with an algorrhytm proposed.

артериальная гипертензиягипертрофия левого желудочкааритмогенный риск

arterial hypertensionleft ventricular hypertrophyarrhythmogenic risk

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