cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2386cardio-91Research ArticleОБЗОРЫREVIEWSГипертрофическая кардиомиопатия и ишемическая болезнь сердца: проблема сочетания патологийHypertrophic cardiomyopathy and ischemic heart disease: the problem of pathology combinationКовалевскаяЕ. А.KovalevskayaE. A.noemail@neicon.ruКрыловаН. С.KrylovaN. S.noemail@neicon.ruПотешкинаН. Г.PoteshkinaN. G.noemail@neicon.ruГБУЗ «Городская клиническая больница № 52» ДЗМРоссияPirogov Russian National Research Medical University; Qty clinical hospital no 52Russian Federation201818112018581S3135Copyright © Kardiomag, 20182018KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/91

Гипертрофическая кардиомиопатия (ГКМП) - заболевание с гипертрофией ЛЖ, вызванной мутациями в генах сократительных белков миокарда, частота которых составляет около 0,5%. В связи с высокой встречаемостью ангинозных болей и выраженными изменениями на ЭКГ при ГКМП проблема диагностики сочетания ГКМП и ИБС представляет достаточно непростую задачу для клинициста. Сложность такой диагностики обусловлена способностью стандартных методов инструментального обследования (ЭКГ, проба с физической нагрузкой, стресс-тесты в сочетании с визуализацией миокарда) выявлять ишемию миокарда как при ИБС, так и при ГКМП. В таких случаях «золотым стандартом» выявления атеросклеротического поражения коронарных артерий остаются коронароангиография либо мультиспиральная компьютерная томография коронарных артерий (у пациентов с низким риском ИБС). Возможность сочетания ГКМП и ИБС у пациентов старших возрастных групп поднимает вопрос об особенностях течения заболеваний и прогнозе таких больных.

Hypertrophic cardiomyopathy (HCM) is a disease with left ventricular hypertrophy caused by mutations in the genes of myocardial contractile proteins, whose frequency is about 0.5%. Due to the high incidence of anginal pain and marked changes in ECG with HCM, the problem of diagnosing the combination of HCM and coronary artery disease (CAD) presents a rather difficult task for the clinician. The complexity of this diagnosis is due to the ability of standard methods of instrumental examination (ECG, a test with physical activity, stress tests in conjunction with visualization of the myocardium) to detect myocardial ischemia in both CAD and HCM. In such cases, the coronary angiography, or multispiral computed tomography of coronary arteries (in patients with low CAD risk) remains the gold standard for detecting atherosclerotic lesions of the coronary arteries. The possibility of combining HCM and CAD in patients of older age groups raises the question of the features of the course of diseases and the prognosis of such patients.

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