Статья
Гиперсимпатикотония в развитии гипертрофии миокарда левого желудочка и возможности бета-блокаторов для регресса
В обзоре рассматривается клиническая значимость гипертрофии левого желудочка (ГЛЖ) — проявление поражения сердца как органа-мишени артериальной гипертонии (АГ). Представлены многообразные механизмы развития ГЛЖ, особое внимание уделено роли симпатической нервной системы и активации β-адренорецепторов в её патогенезе. Описаны основополагающие современные методы диагностики ГЛЖ, дана их сравнительная характеристика. С позиций актуальных международных рекомендаций детально изложены эхокардиографические принципы выявления и классификации данного состояния. Приведена эпидемиологическая характеристика распространённости ГЛЖ. С учетом имеющейся на сегодняшний день научной базы подробно рассмотрена прогностическая значимость ГЛЖ как фактора, увеличивающего риск фатальных и нефатальных сердечно-сосудистых, цереброваскулярных и почечных осложнений у больных с АГ. Представлены результаты исследований, свидетельствующие о регрессе ГЛЖ на фоне лечения высокоселективным β1-блокатором бисопрололом. Обсуждаются патофизиологические механизмы регресса ГЛЖ на фоне применения β1-блокаторов.
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