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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">arthyper</journal-id><journal-title-group><journal-title xml:lang="ru">Артериальная гипертензия</journal-title><trans-title-group xml:lang="en"><trans-title>"Arterial’naya Gipertenziya" ("Arterial Hypertension")</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-419X</issn><issn pub-type="epub">2411-8524</issn><publisher><publisher-name>Antihypertensive League</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18705/1607-419X-2014-20-3-189-200</article-id><article-id custom-type="elpub" pub-id-type="custom">arthyper-62</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНАЯ СТАТЬЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLE</subject></subj-group></article-categories><title-group><article-title>ОЦЕНКА СОСТОЯНИЯ МЕТАБОЛИЗМА И ПЕРФУЗИИ МИОКАРДА ПРИ НЕКОРОНАРОГЕННЫХ ЖЕЛУДОЧКОВЫХ НАРУШЕНИЯХ РИТМА</article-title><trans-title-group xml:lang="en"><trans-title>ASSESSMENT OF PERFUSION AND METABOLISM OF MYOCARDIUM IN NONCORONAROGENIC VENTRICULAR ARRHYTHMIA</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пармон</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Parmon</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ведущий научный сотрудник, директор ФМИЦ им. В.А. Алмазова.</p><p>Контактная информация: ФГБУ «Федеральный медицинский исследовательский центр имени В.А. Алмазова» Минздрава России, ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341. Тел.: +7 (812) 702–68–27, +7 911–212–08–36. E-mail: parmon@almazovcentre.ru (Пармон Елена Валерьевна).</p></bio><email xlink:type="simple">parmon@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рыжкова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ryzhkova</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ведущий научный сотрудник, заведующая научно-исследовательской лабораторией ядерной кардиологии ФМИЦ им. В.А. Алмазова .ru (Пармон Елена Валерьевна).</p><p> </p></bio><email xlink:type="simple">parmon@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральный медицинский  исследовательский центр имени В.А. Алмазова, Санкт-Петербург<country>Россия</country></aff><aff xml:lang="en">Federal Almazov Medical Research Centre, St Petersburg<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>27</day><month>02</month><year>2015</year></pub-date><volume>20</volume><issue>3</issue><fpage>189</fpage><lpage>200</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Пармон Е.В., Рыжкова Е.В., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Пармон Е.В., Рыжкова Е.В.</copyright-holder><copyright-holder xml:lang="en">Parmon E.V., Ryzhkova D.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://htn.almazovcentre.ru/jour/article/view/62">https://htn.almazovcentre.ru/jour/article/view/62</self-uri><abstract><p>Состояние метаболизма и перфузии миокарда у пациентов с некоронарогенными аритмиями, в частности с желудочковыми нарушениями ритма (ЖНР) изучено недостаточно. Большая надежда возлагается на лучевые технологии визуализации сердца, в том числе методики ядерной медицины.</p><p>Целью исследования явилась оценка состояния перфузии и метаболизма жирных кислот (ЖК) в миокарде у пациентов с некоронарогенной желудочковой аритмией с помощью позитронной эмиссионной томографии (ПЭТ) миокарда с С-бутиратом натрия (С-БН) и перфузионной однофотонной эмиссионной компьютерной томографии с 99mТс-тетрафосмином в покое и на фоне пробы с физической нагрузкой (ФН).</p><sec><title>Материалы и методы</title><p>Материалы и методы. Обследовано 3 группы пациентов: 16 пациентов с ЖНР некоронарогенной природы (9 мужчин и 7 женщин, средний возраст — 44 ± 6,5 года) и 2 контрольных группы по 10 человек [для выявления закономерности захвата и распределения радиофармпрепарата (РФП) в норме и при явном дефекте перфузии], сопоставимые по полу и возрасту: одна — с доказанной ишемической болезнью сердца (ИБС) и ЖНР, вторая — здоровые лица.</p></sec><sec><title>Результаты</title><p>Результаты. У здоровых пациентов наблюдалось равномерное распределение перфузионного РФП в миокарде левого желудочка, отсутствие дефектов перфузии, равномерное распределение и быстрое выведение С-БН. У пациентов с ИБС отмечались стабильные или преходящие дефекты перфузии, снижение экстракции и замедление метаболизма ЖК в участках нарушений перфузии. В изучаемой группе по данным ПЭТ у большинства (93,75 %) были выявлены незначительной степени нарушения перфузии миокарда: диффузная гетерогенность в покое без соответствия бассейну определенной коронарной артерии при ФН и диффузно-неравномерная аккумуляция свободных ЖК без изменения периода полувыведения РФП. Изменения были схожи как у пациентов с известной причиной ЖНР, так и без таковой.</p></sec><sec><title> Выводы</title><p> Выводы. Таким образом, используемые радионуклидные методики являются надежными методами оценки перфузии и метаболизма миокарда и позволяют исключить ишемическую природу заболевания аритмии и судить об имеющейся одинаковой неоднородности микроциркуляции и метаболизма при различных заболеваниях, которые объединяет синдром желудочковой аритмии. </p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Objective</title><p>Objective. To analyze myocardial blood low and metabolism in patients with high gradation nonischemic ventricular arrhythmia (VA).</p></sec><sec><title>Design and methods</title><p>Design and methods. Sixteen patients (9 males, 7 females, average age — 44 ± 99м 6,5 years) were enrolled. One-photon emission computer tomography with Tc-tetraphosmine at rest and at the physical training (veloergometry) were performed for myocardial perfusion examination. Estimation of fatty acids metabolism in myocardium was performed by positron-emission tomography (PET) with С-natrium butyrate. Control groups included age- and sex-matched 10 patients with coronary artery disease (CAD) and VA and 10 99м healthy volunteers.</p></sec><sec><title>Results</title><p>Results. At rest diffused equal distribution of Tc-tetraphosmine was revealed in 93,75 % patients. Reversible diffused stress-induced defects were found at exercise training test, but the changes were not signiicant. There were no changes in myocardial metabolism and no changes in the rate of fatty acids metabolism. Thus, diffused changes of metabolism and perfusion of left ventricle were found in the most patients with VA. Whereas there were no changes in healthy volunteers, and we found reduced extraction and velocity of fatty acids utilization in areas of left ventricle with stress-induced changes of perfusion in the group with CAD and VA.</p></sec><sec><title> Conclusions</title><p> Conclusions. PET is an effective method to conirm nonischemic character of VA, and in most cases of VA it is helpful to ind diffused changes of metabolism and perfusion of left ventricle. These might be important when a treatment approach is to be chosen.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>желудочковая аритмия</kwd><kwd>перфузия</kwd><kwd>метаболизм</kwd><kwd>позитронно-эмиссионная томография</kwd><kwd>однофотонно-эмиссионная компьютерная томография</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ventricular arrhythmia</kwd><kwd>perfusion</kwd><kwd>metabolism</kwd><kwd>positron-emission tomography</kwd><kwd>one-photon emission computer tomography</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Wever E.F., Robles de Medina E.O. Sudden death in patients without structural heart disease // J. Am. Coll. Cardiol. — 2004. — Vol. 43, № 7. — P. 1137–1144.</mixed-citation><mixed-citation xml:lang="en">Wever E.F., Robles de Medina E.O. Sudden death in patients without structural heart disease // J. Am. Coll. 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