docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-4-15-19docru-112Research ArticleОБЗОРЫREVIEWSРоль субклинического гипотиреоза в патогенезе и течении хронической сердечной недостаточностиThe Role of Subclinical Hypothyroidism in the Pathogenesis and Course of Chronic Heart Failurehttps://orcid.org/0009-0001-2544-7306МикульскийА. С.MikulskyA. S.

Микульский Антон Сергеевич — слушатель ординатуры по специальности «терапия»

194044, г. Санкт-Петербург, ул. Академика Лебедева, д. 6

Mikulsky, A.S.

6 Academician Lebedev Str., Saint Petersburg, 194044

krasnodarovskiy@gmail.comhttps://orcid.org/0000-0002-6489-9938КутелевГ. Г.KutelevG. G.

Кутелев Геннадий Геннадьевич — д. м. н., старший преподаватель кафедры и клиники военно-морской терапии

198013, г. Санкт-Петербург, Загородный пр-т, д. 47

Kutelev, G.G.

6 Academician Lebedev Str., Saint Petersburg, 194044

gena08@yandex.ruhttps://orcid.org/0000-0002-3141-7111ШуленинК. С.ShuleninK. S.

Шуленин Константин Сергеевич — д. м. н., доцент, заместитель начальника кафедры и клиники военно-морской терапии

198013, г. Санкт-Петербург, Загородный пр-т, д. 47

Shulenin, K.S.

6 Academician Lebedev Str., Saint Petersburg, 194044

shulenink@mail.ruhttps://orcid.org/0009-0000-4342-9163СальниковМ. В.SalnikovM. V.

Сальников Максим Владимирович — слушатель 6-го курса факультета подготовки врачей для Военно-морского флота

194044, г. Санкт-Петербург, ул. Академика Лебедева, д. 6

Salnikov, M.V.

6 Academician Lebedev Str., Saint Petersburg, 194044

maxzzs@yandex.ruФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны РоссииРоссияS.M. Kirov Military Medical AcademyRussian Federation2024160220252341519Copyright © Микульский А.С., Кутелев Г.Г., Шуленин К.С., Сальников М.В., 20252025Микульский А.С., Кутелев Г.Г., Шуленин К.С., Сальников М.В.Mikulsky A.S., Kutelev G.G., Shulenin K.S., Salnikov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/112Цель обзора

Цель обзора. Обобщить имеющиеся в настоящее время сведения о механизме развития хронической сердечной недостаточности на фоне субклинического гипотиреоза.

Основные положения

Основные положения. Обзорная статья посвящена влиянию субклинического гипотиреоза на течение сердечно-сосудистых патологий, в частности хронической сердечной недостаточности. Представлены механизмы молекулярно-клеточных нарушений при данном заболевании. Особая роль отведена белку миокарда фосфоламбану. Описано значение субклинического гипотиреоза как фактора риска и как самостоятельной нозологии в рамках коморбидных состояний, связанных с патологией сосудистого русла. Показан патогенез возникновения у пациентов дисфункции левого желудочка и, как следствие, хронической сердечной недостаточности на фоне субклинического гипотиреоза. Приведены данные исследований пациентов с сердечно-сосудистыми заболеваниями на фоне повышенного уровня тиреотропного гормона. Затрагивается также тема взаимосвязи нарушений сердечного ритма и недостаточности гормонов щитовидной железы.

Заключение

Заключение. Установлена роль субклинического гипотиреоза в патогенезе хронической сердечной недостаточности не только как фактора риска ее развития, но и как самостоятельной нозологической формы, наличие которой закономерно приводит к неблагоприятным сердечно-сосудистым событиям.

Aim

Aim. To summarize the currently available information about the mechanism of development of chronic heart failure against the background of subclinical hypothyroidism.

Key points

Key points. The review article is devoted to the influence of subclinical hypothyroidism on the course of cardiovascular pathologies, in particular chronic heart failure. The mechanisms of molecular cellular disorders in this disease are presented. A special role is assigned to the protein of the myocardium phospholamban. The importance of subclinical hypothyroidism as a risk factor and as an independent nosology within the framework of comorbid conditions associated with pathology of the vascular bed is described. The pathogenesis of left ventricular dysfunction in a patient and, as a consequence, chronic heart failure in patients with subclinical hypothyroidism is shown. Data from studies of patients with cardiovascular diseases against the background of elevated thyroid stimulating hormones levels are presented. The topic of the relationship between heart rhythm disturbances and thyroid hormone deficiency is also touched upon.

Conclusion

Conclusion. The role of subclinical hypothyroidism in the pathogenesis of chronic heart failure has been established, not only as a risk factor for its development, but also as an independent nosological form, the presence of which naturally leads to adverse cardiovascular events.

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