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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">avk</journal-id><journal-title-group><journal-title xml:lang="ru">Архивъ внутренней медицины</journal-title><trans-title-group xml:lang="en"><trans-title>The Russian Archives of Internal Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-6704</issn><issn pub-type="epub">2411-6564</issn><publisher><publisher-name>“SINAPS” LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20514/2226-6704-2022-12-3-165-174</article-id><article-id custom-type="elpub" pub-id-type="custom">avk-1427</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>ОБЗОРНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group></article-categories><title-group><article-title>БЕЗБОЛЕВАЯ ИШЕМИЯ МИОКАРДА У ПАЦИЕНТОВ ПОСЛЕ ПРОВЕДЕННОГО ЧРЕСКОЖНОГО КОРОНАРНОГО ВМЕШАТЕЛЬСТВА</article-title><trans-title-group xml:lang="en"><trans-title>Silent Myocardial Ischemia in Patients after Permanent Coronary Intervention</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0769-3682</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдрахманова</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdrahmanova</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алсу Ильдусовна Абдрахмановакафедра Фундаментальных основ клинической медицины; отделение кардиологии</p><p>Казань</p></bio><bio xml:lang="en"><p>Alsu I. Abdrahmanova</p><p>Kazan</p></bio><email xlink:type="simple">alsuchaa@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1343-0478</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цибулькин</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsibulkin</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кафедра кардиологии, рентгенэндоваскулярной и сердечно — сосудистой хирургии</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0009-9103</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Амиров</surname><given-names>Н. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Amirov</surname><given-names>N. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кафедра Фундаментальных основ клинической медицины; кафедра поликлинической терапии и общей врачебной практики</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0975-7002</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хабибуллин</surname><given-names>И. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Khabibullin</surname><given-names>I. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>отделение кардиологии</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3991-2157</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Горнаева</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Gornaeva</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>отделение кардиологии</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4359-4657</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Галимзянова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Galimzyanova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>отделение кардиологии</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4925-7128</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Елагина</surname><given-names>Д. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Elagina</surname><given-names>D. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кафедра Фундаментальных основ клинической медицины</p><p>Казань</p></bio><bio xml:lang="en"><p>Kazan</p></bio><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Казанский (Приволжский) федеральный университет»; ГАУЗ «Межрегиональный клинико-диагностический центр»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan Federal University; GAUZ “Interregional Clinical Diagnostic Center”</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan State Medical Academy</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО «Казанский (Приволжский) федеральный университет»; ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; МСЧ МВД России по РТ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan Federal University; Kazan state medical university; MSU MVD</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГАУЗ «Межрегиональный клинико-диагностический центр»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>GAUZ “Interregional Clinical Diagnostic Center”</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГАОУ ВО «Казанский (Приволжский) федеральный университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kazan Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>20</day><month>05</month><year>2022</year></pub-date><volume>12</volume><issue>3</issue><fpage>165</fpage><lpage>174</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абдрахманова А.И., Цибулькин Н.А., Амиров Н.Б., Хабибуллин И.М., Горнаева Л.И., Галимзянова Л.А., Елагина Д.С., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Абдрахманова А.И., Цибулькин Н.А., Амиров Н.Б., Хабибуллин И.М., Горнаева Л.И., Галимзянова Л.А., Елагина Д.С.</copyright-holder><copyright-holder xml:lang="en">Abdrahmanova A.I., Tsibulkin N.A., Amirov N.B., Khabibullin I.M., Gornaeva L.I., Galimzyanova L.A., Elagina D.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" 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://www.medarhive.ru/jour/article/view/1427">https://www.medarhive.ru/jour/article/view/1427</self-uri><abstract><p>По данным литературы были проанализированы частота и срок возникновения ишемии миокарда, в том числе безболевой ишемии, у пациентов после проведенного чрескожного коронарного вмешательства. Фактором риска возникновения рестеноза стента у пациентов после чрескожного коронарного вмешательства является безболевая ишемия миокарда. Наличие безболевой ишемии миокарда само по себе может указывать на степень тяжести органических изменений в коронарных артериях. Следствием этого является необходимость выявления рестеноза, которое может осуществляться с помощью нагрузочных проб с визуализацией. Данные пробы также помогают выявить ишемию миокарда и скрытую коронарную недостаточность. Безболевая ишемия миокарда обнаруживается у четверти пациентов после чрескожного коронарного вмешательства. Безболевой инфаркт миокарда составляет 22-78 % от всех инфарктов после чрескожного коронарного вмешательства. Для определения наличия ишемии миокарда, в том числе скрытой коронарной недостаточности, а также с целью своевременной диагностики рестеноза и снижения частоты осложнений, могут быть использованы диагностические нагрузочные пробы, в частности, однофотонная эмиссионная компьютерная томография. Ее использование может быть целесообразно для выявления пациентов с высоким риском развития рестеноза, определения показаний к проведению повторного чрескожного коронарного вмешательства, а также для оценки прогноза после реваскуляризации. При отсутствии клинической симптоматики коронарной недостаточности после чрескожного коронарного вмешательства, пробы с физической нагрузкой рекомендуется проводить в первые два года после реваскуляризации. Пробы с физической нагрузкой необходимо проводить в более ранние сроки при следующих условиях: наличие высокого сердечно-сосудистого риска, неполная или субоптимальная реваскуляризация, стентирование коронарной артерии малого диаметра, бифуркационное или устьевое стентирование. Своевременная диагностика безболевой ишемии миокарда с помощью однофотонной эмиссионной компьютерной томографии у пациентов, перенесших чрескожное коронарное вмешательство, является важной задачей клинической практики.</p></abstract><trans-abstract xml:lang="en"><p>Frequency and timing of appearance of myocardial ischemia, including silent ischemia, were analyzed in published scientific sources. Silent myocardial ischemia is risk factor for stent restenosis after percutaneous coronary interventions. Patients with silent ischemia lack clinical symptoms while perfusion, metabolic and electrical activity of their myocardium may be compromised. These patients do not have warning clinical symptoms during physical exercise and do not stop inappropriate activity. Silent myocardial ischemia itself can indicate severity of atherosclerosis in coronary arteries. High probability of stent restenosis can be assessed by exercise tests prior to coronary angiography. These tests also allow to reveal clinically silent myocardial ischemia. Quarter of patients after coronary intervention develop silent myocardial ischemia. Silent myocardial infarction comprises 22-78 % of all infarctions after coronary interventions. Exercise tests based on single-photon emitting computed tomography can be used in diagnosing stent restenosis, silent ischemia and assessment of cardiovascular risk in patients after coronary interventions. Its results can be used as indications for repeated coronary interventions and for prognosis after revascularization. Exercise tests are recommended in two years after revascularization in absence of ischemic symptoms. Early tests are recommended in cases of high cardiovascular risk, suboptimal revascularization, stenting of arteries with small diameter or at bifurcation. Diagnosis of silent myocardial ischemia by single-photon emitting computed tomography in patients after coronary revascularization is significant for clinical practice.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>безболевая ишемия миокарда</kwd><kwd>чрезкожное коронарное вмешательство</kwd></kwd-group><kwd-group xml:lang="en"><kwd>silent myocardial ischemia</kwd><kwd>percutaneous coronary intervention</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">Cassese S., Byrne R.A., Schulz S. et al. Prognostic role of restenosis in 10 004 patients undergoing routine control angiography after coronary stenting. 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