cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-2281cardiovascular-2281Research ArticleОБЗОРЫREVIEWSЗначение лимфатической системы сердца в развитии и прогрессировании сердечной недостаточности и новых терапевтических подходах ее коррекции при постинфарктном ремоделированииThe role of the cardiac lymphatic system in the development and progression of heart failure and novel therapeutic approaches for its management in post-infarction cardiac remodelinghttps://orcid.org/0000-0002-8080-904XКорневаЮ. С.KornevaYu. S.

Корнева Юлия Сергеевна — кандидат медицинских наук, доцент кафедры патологической анатомии ФГБОУ ВО “Смоленский государственный медицинский университет” Минздрава России, врач-патологоанатом ОГБУЗ “Смоленский областной институт патологии”

214019, Смоленск, ул. Крупской 28,

214020, Смоленск, пр. Гагарина 27

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ksu1546@yandex.ruhttps://orcid.org/0000-0002-0590-1399УкраинецР. В.UkrainetsR. V.

Украинец Роман Вадимович — ординатор кафедры патологической анатомии

214019, Смоленск, ул. Тенишевой 11а

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ukrainets.roman@yandex.ruФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России; ОГБУЗ «Смоленский областной институт патологии»Smolensk State Medical University; Smolensk Regional Institute of PathologyФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава РоссииSmolensk State Medical University20200105202019322812281Copyright © Корнева Ю.С., Украинец Р.В., 20202020Корнева Ю.С., Украинец Р.В.Korneva Y.S., Ukrainets R.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2281

Лимфатические сосуды сердца играют жизненно важную роль в поддержании его гомеостаза как при физиологических, так и при патологических состояниях, обеспечивая своевременный отток метаболитов. Показано, что при инфаркте миокарда и постинфарктном ремоделировании происходит перестройка лимфатического русла, что влечет за собой функциональные нарушения, имеющие большое значение в патогенезе хронической сердечной недостаточности. При этом формируется порочный круг: вследствие прогрессирующего отека миокарда нарастают гипоксия и фиброз интерстициального пространства, усугубляющие отек. Запускаются другие механизмы, связанные с дополнительным повреждением миокарда и снижением его сократительной способности. Нарушение лимфооттока связано с возникновением аритмий. На экспериментальных моделях было показано положительное влияние экзогенной активации лимфангиогенеза в отношении профилактики и лечения сердечной недостаточности, что в дальнейшем может использоваться для коррекции схем лечения. В представленном обзоре рассматривается ремоделирование лимфатической сети сердца после инфаркта миокарда, а также патогенетические механизмы развития связанных с этим осложнений.

Cardiac lymphatic vessels play a vital role in maintaining homeostasis in both physiological and pathological conditions, providing outflow of metabolites. It has been shown that myocardial infarction and postinfarction cardiac remodeling is accompanied by the lymphatic remodeling, which entails functional disorders and is of great importance in heart failure pathogenesis. As a result of progressive myocardial edema, hypoxia and fibrosis of the interstitial space increase, aggravating edema. Other pathways of additional myocardial damage and contractility reduction are triggered. Lymphatic efflux is associated with arrhythmias. Experimental models showed the positive effect of exogenous activation of lymphangiogenesis in relation to the prevention and treatment of heart failure, which can be further used to improve treatment regimens. This review discusses cardiac lymphatic remodeling after myocardial infarction, as well as the pathogenesis of related complications.

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