arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-5-509-521arthyper-2026Research ArticleСтатьиArticlesНейрогенные сердечно-сосудистые нарушения при α-синуклеинопатиях: сложные вопросы диагностики и терапииNeurogenic cardiovascular disorders in α-synucleinopathies: diagnostic and therapy issueshttps://orcid.org/0000-0001-8988-3011ЛитвиненкоИ. В.LitvinenkoI. V.

Санкт-Петербург

Igor V. Litvinenko, MD, Head, Faculty Department of Neurology n. a. M. I. Astvatsaturov

St Petersburg

litvinenkoiv@rambler.ruhttps://orcid.org/0000-0001-5006-8394ДынинП. С.DyninP. S.

Санкт-Петербург

Pavel S. Dynin, MD, PhD, Academic Lecturer, Department of Neurology Diseases

St Petersburg

pavdynin@yandex.ruhttps://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskyS. N.

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Stanislav N. Yanishevsky, MD, PhD, DSc, Associate Professor, Head, Research Laboratory for Neurology and Neurorehabilitation

Akkuratov street, St Petersburg, 197341

stasya71@yandex.ruhttps://orcid.org/0000-0003-3109-8795ЛобзинВ. Ю.LobzinV. Yu.

Санкт-Петербург

Vladimir Yu. Lobzin, MD, PhD, DSc, Professor, Department of Neurology Diseases

St Petersburg

vladimirlobzin@mail.ruhttps://orcid.org/0000-0001-7039-2423НаумовК. М.NaumovK. M.

Санкт-Петербург

Konstantin M. Naumov, MD, PhD, Senior Academic Lecturer, Department of Neurology Diseases,

St Petersburg

naumov_k@list.ruФедеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С. М. Кирова» Министерства обороны Российской ФедерацииРоссияMilitary-Medical Academy named author S. M. KirovRussian FederationФедеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С. М. Кирова» Министерства обороны Российской Федерации; Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияMilitary-Medical Academy named author S. M. Kirov; Almazov National Medical Research CentreRussian Federation202119082021275509521Copyright © Литвиненко И.В., Дынин П.С., Янишевский С.Н., Лобзин В.Ю., Наумов К.М., 20222022Литвиненко И.В., Дынин П.С., Янишевский С.Н., Лобзин В.Ю., Наумов К.М.Litvinenko I.V., Dynin P.S., Yanishevsky S.N., Lobzin V.Y., Naumov K.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2026

Трудности выявления и диагностики нейрогенных сердечно-сосудистых нарушений при α-синуклеинопатиях обусловлены возможным ранним изолированным дебютом вегетативного дефицита при данной группе заболеваний, маскированием под другие нозологические формы. В настоящей статье отражены особенности механизмов развития и прогрессирования патологических и клинических проявлений нейрогенной сердечно-сосудистой патологии. Указаны основные формы ее проявлений: нейрогенная ортостатическая гипотензия, нейрогенная гипертензия горизонтального положения, ее отдельный вариант — ночная гипертензия горизонтального положения. Описаны основные существующие и перспективные диагностические возможности выявления сердечно-сосудистых нарушений нейрогенной природы. Отражены основные трудности, возникающие перед специалистом при проведении дифференциальной диагностики данных проявлений. Обращено внимание на возможную взаимосвязь сердечно-сосудистых нарушений при α-синуклеинопатиях и проявлений данной группы заболеваний. Представлены возможный диагностический алгоритм и возможные немедикаментозные и медикаментозные способы коррекции и профилактики нейрогенного сердечно-сосудистого дефицита при α-синуклеинопатиях. Показана важность мультидисциплинарного подхода.

Diagnostics and treatment of the neurogenic cardiovascular disorders in α-synucleinopathies are difficult due to the early-onset of autonomic deficiency and masking under other diseases. The paper discusses the development and progression mechanisms of manifestations of neurogenic cardiovascular pathology. The main forms include neurogenic orthostatic hypotension, neurogenic hypertension in supine position (recumbent neurogenic hypertension) and its nocturnal variant. The existing and promising diagnostic approaches and related difficulties are presented. The possible relationship of cardiovascular disorders in α-synucleinopathies and their manifestations is shown. A possible diagnostic algorithm and possible non-drug and drug treatment and prevention approaches in neurogenic cardiovascular deficiency in α-synucleinopathies are presented. The importance of a multidisciplinary approach is emphasized.

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