fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2020-6-2-103-115fcmedicine-410Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESПервичная профилактика фибрилляции предсердий у больных метаболическим синдромом: роль коррекции потенциально модифицируемых факторовPrimary prevention of atrial fibrillation in patients with metabolic syndrome: correction of modifiable risk factorshttps://orcid.org/0000-0001-7827-1052ОлесинА. И.OlesinA. I.

доктор медицинских наук, профессор кафедры госпитальной терапии и кардиологии им. М.С. Кушаковского,

191015, г. Санкт-Петербург, ул. Кирочная, д. 41

MD, DSc, Professor, Department of Clinical Therapy and Cardiology, 

41, Kirochnaya Street, St. Petersburg, 191015

olesin58@mail.ruhttps://orcid.org/0000-0003-3350-3088КонстантиноваИ. В.KonstantinovaI. V.

кандидат медицинских наук, доцент кафедры госпитальной терапии и кардиологии им. М.С.Кушаковского,

191015, г. Санкт-Петербург, ул. Кирочная, д. 41

MD, PhD, Assistant Professor, Department of Clinical Therapy and Cardiology, 

41, Kirochnaya Street, St. Petersburg, 191015

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияMechnikov North-West State Medical UniversityRussian Federation20210107202162103115Copyright © Олесин А.И., Константинова И.В., 20212021Олесин А.И., Константинова И.В.Olesin A.I., Konstantinova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/410

В настоящее время около 34 миллионов человек во всем мире страдают фибрилляцией предсердий, причем к 2060 году прогнозируется удвоение их количества. Несмотря на разработанные в последние годы принципы терапии различных клинических форм фибрилляции предсердий, ее возникновение связано с повышенным риском развития осложнений, таких, как системные тромбоэмболии, прогрессирование сердечной недостаточности, инсульт, инфаркт миокарда и т.д. Фибрилляция предсердий, из-за высокого риска инвалидизации и смертности, представляет собой как социальную, так и экономическую проблему для здравоохранения большинства стран мира, в том числе обусловленную значительными финансовыми затратами, направленными на ее лечение.

Основной целью как российского, так и здравоохранения других стран является снижение смертности от сердечно-сосудистых заболеваний. В настоящее время комитетом ВОЗ ожирение, представленное в большинстве случаев метаболическим синдромом, а также фибрилляция предсердий названы «эпидемиями XXI века». Фибрилляция предсердий, однажды развившись, практически всегда рецидивирует, переходя, в конечном итоге, из пароксизмальной или персистирующей в перманентную форму. Известны многочисленные причины и факторы риска развития фибрилляции предсердий, однако наиболее частой причиной является метаболический синдром. В настоящем обзоре представлен анализ потенциальных предикторов развития фибрилляции предсердий у больных метаболическим синдромом: влияние абдоминального ожирения и избыточного индекса массы тела, артериальной гипертензии, гипергликемии и гиперлипидемии, роль воспаления перикардиальной жировой ткани, влияние обструктивного апноэ во время сна, злоупотребления алкоголем, кофе, энергетическими напитками, табакокурением. Обсуждаются электрофизиологические механизмы развития фибрилляции предсердий у больных метаболическим синдромом, риск развития фибрилляции предсердий, а также основные направления первичной профилактики этой аритмии. 

Currently, around 34 million people worldwide suffer from atrial fibrillation (AF), with the number projected to double by 2060. Despite the treatment of AF has been significantly improved during the recent years, AF is still associated with an increased risk of severe complications such as systemic thromboembolism, progression of heart failure, stroke, and myocardial infarction. Due to a high risk of disability and mortality, AF represent a major socioeconomic problem for the healthcare in most countries, also because of related financial costs. Obesity, most often represented by metabolic syndrome, is widely recognized as an epidemic of the XXI century. Here we review the features of AF development in patients with metabolic syndrome, suggesting novel avenues for the primary prevention of AF. 

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