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Кардиоваскулярная терапия и профилактика

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Гипертрофия левого желудочка при артериальной гипертензии и риск развития аритмий

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Аннотация

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.

 

Об авторах

И. Г. Фомина
Московская медицинская академия им. И.М.Сеченова на базе ГКБ № 61. Москва
Россия


Т. А. Дьякова
Московская медицинская академия им. И.М.Сеченова на базе ГКБ № 61. Москва
Россия


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Для цитирования:


Фомина И.Г., Дьякова Т.А. Гипертрофия левого желудочка при артериальной гипертензии и риск развития аритмий. Кардиоваскулярная терапия и профилактика. 2006;5(8):83-89.

For citation:


Fomina I.G., Dyakova T.A. Left ventricular hypertrophy in arterial hypertension and arrhythmia risk. Cardiovascular Therapy and Prevention. 2006;5(8):83-89. (In Russ.)

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