avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-5-335-343avk-1296Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESИнфекционный эндокардит у пациентов с гипертрофической кардиомиопатиейInfective Endocarditis in Patients with Hypertrophic Cardiomyopathyhttps://orcid.org/0000-0001-6187-7525ПономареваЕ. Ю.PonomarevaE. Yu.

Саратов

Saratov

https://orcid.org/0000-0003-3611-1186ИгнатенкоГ. А.IgnatenkoG. A.

Донецк

Donetsk

https://orcid.org/0000-0003-3984-8482ТарадинГ. Г.TaradinG. G.

Геннадий Геннадьевич Тарадин

Донецк

Gennadiy G. Taradin

Donetsk

taradin@inbox.ruФГБОУ ВО Саратовский государственный медицинский университет им. В.И. Разумовского Минздрава России, кафедра госпитальной терапии лечебного факультетаРоссияFederal State Budgetary Educational Institution of Higher Education «Saratov State Medical University named after V.I. Razumovsky»Russian FederationГОО ВПО «Донецкий национальный медицинский университет им. М. Горького»РоссияState Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»Russian FederationГОО ВПО «Донецкий национальный медицинский университет им. М. Горького»; ГУ «Институт неотложной и восстановительной хирургии им. В.К. Гусака», отдел неотложной и восстановительной кардиохирургииРоссияState Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»; State Institution «V.K. Gusak Institute of Urgent and Recovery Surgery»Russian Federation202127092021115335343Copyright © Пономарева Е.Ю., Игнатенко Г.А., Тарадин Г.Г., 20212021Пономарева Е.Ю., Игнатенко Г.А., Тарадин Г.Г.Ponomareva E.Y., Ignatenko G.A., Taradin G.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1296

Представлен обзор литературы, отражающий частоту возникновения, особенности этиологии, гемодинамики, локализации, клинических проявлений, исходов и лечения инфекционного эндокардита (ИЭ) у пациентов с гипертрофической кардиомиопатией (ГКМП). Несмотря на относительную редкость возникновения ИЭ у больных ГКМП, сочетание этих патологий характеризуется взаимным отягощением и неблагоприятным прогнозом. У больных с обструктивными формами ГКМП присоединение ИЭ усугубляет расстройства кровообращения и повышает вероятность неконтролируемого сепсиса и эмболий, увеличивая тем самым риск летального исхода. Консервативное лечение ИЭ у больных с ГКМП не отличается от такового без ГКМП. Необходимо междисциплинарное взаимодействие при ведении пациентов с ИЭ на фоне ГКМП в определении показаний к кардиохирургическому лечению и выборе оптимального метода. Антибактериальная профилактика ИЭ перед инвазивными медицинскими манипуляциями у пациентов с ГКМП не рекомендуется действующими согласительными документами, однако решение для каждого больного должно приниматься индивидуально с обязательной оценкой риска возникновения ИЭ, тяжести гемодинамических нарушений и прогноза.

A literature review is presented, reflecting the incidence, etiology, hemodynamics, localization, clinical manifestations, outcomes and treatment of infective endocarditis (IE) in patients with hypertrophic cardiomyopathy (HCM). Despite the relative rarity of IE in patients with HCM, the combination of these pathologies is characterized by mutual aggravation and poor prognosis. The addition of IE increases the risk of death in patients with obstructive HCM, deteriorating circulatory disorders, increasing the likelihood of uncontrolled sepsis and embolism. Conservative treatment of IE in patients with HCM does not differ from that without HCM. Interdisciplinary interaction is needed in the management of patients with IE against the background of HCM in determining the indications for cardiac surgery and choosing the optimal method. Antibacterial prophylaxis of IE before invasive medical manipulations in patients with HCM is not recommended by the current consensus documents, however, the decision for each patient should be made individually, with a mandatory assessment of the risk of IE, the severity of hemodynamic disorders and prognosis.

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