cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-2558cardiovascular-2558Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESПрогностическое значение мозгового натрийуретического пептида для оценки риска сердечно-сосудистых осложнений при внесердечных хирургических вмешательствахPredictive value of brain natriuretic peptide for cardiovascular risk assessment in non-cardiac surgeryhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DzhioevaO. N.

Оксана Михайловна Драпкина — доктор медицинских наук, профессор, член-корр. РАН, директор.

Москва

 

Moscow

ODrapkina@gnicpm.ruhttps://orcid.org/0000-0002-5384-3795ДжиоеваО. Н.DrapkinaO. M.

Ольга Николаевна Джиоева — кандидат медицинских наук, старший научный сотрудник отдела фундаментальных и прикладных аспектов ожирения.

Москва, Тел.: +7 (916) 614-18-21

Moscow

o.dzhioeva@yandex.ruФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииNational Medical Research Center for Therapy and Preventive Medicine.20201411202019525582558Copyright © Драпкина О.М., Джиоева О.Н., 20202020Драпкина О.М., Джиоева О.Н.Dzhioeva O.N., Drapkina O.M.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/2558

Частота осложнений, связанных с оперативным вмешательством, за последние 30 лет существенно снизилась, однако последствия после хирургических манипуляций все еще являются серьезной клинической проблемой. Выявление интра- и послеоперационного повреждения миокарда является сложной задачей, поскольку почти половина всех осложнений отмечается у пациентов, исходно не входящих в группу высокого риска без заболеваний сердца в анамнезе. В настоящее время несколько крупных исследований и метаанализов, результаты которых были опубликованы за последние 5 лет, рекомендуют использование определения мозговых натрийуретических пептидов для стратификации риска у всех пациентов, готовящихся к плановой внесердечной хирургической операции, с целью улучшения послеоперационного исхода. Мониторинг уровня натрийуретических пептидов у пациентов в течение всего пери-операционного периода может способствовать лучшему пониманию патофизиологии развития кардиальных осложнений при внесердечных хирургических вмешательствах. Внедрение новых критериев позволит качественно улучшить оказание помощи коморбидным пациентам, снизить количество послеоперационных осложнений и улучшить междисциплинарные взаимодействия специалистов в рамках командной работы.

The incidence of postoperative complications has decreased significantly over the past 30 years, but the consequences after surgery are still a serious clinical problem. Identifying intra- and postoperative myocardial injury is a challenging task, since almost half of all complications occur in patients who were not initially at high risk without a history of heart disease. Currently, several large studies and meta-analyzes over the past 5 years recommend the determining brain natriuretic peptide (BNP) levels for risk stratification in all patients scheduled for elective non-cardiac surgery in order to improve the postoperative outcome. Monitoring of BNP level during the entire perioperative period can contribute to a better understanding of the pathophysiology of cardiac complications in noncardiac surgery. The introduction of new criteria will qualitatively improve care to patients with comorbidities, reduce the number of postoperative complications and improve interdisciplinary interactions of specialists.

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